Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients.
Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patien...
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2021
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oai:doaj.org-article:cd0d8eced2204a44936cdb5b3a8cd8c52021-12-02T20:16:06ZAssociation between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients.1932-620310.1371/journal.pone.0260656https://doaj.org/article/cd0d8eced2204a44936cdb5b3a8cd8c52021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260656https://doaj.org/toc/1932-6203Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patients and evaluating the impact of voriconazole concentrations on adverse effects. A 2-year retrospective multicenter cohort study (NCT04502771) was conducted in six intensive care units. Adult patients who had at least one voriconazole TDM were included. Univariable and multivariable linear regression analyses were performed to identify predictors of voriconazole concentrations, and univariable logistic regression analysis, to study the relationship between voriconazole concentrations and adverse effects. During the 2-year study period, 70 patients were included. Optimal trough voriconazole concentrations were reported in 37 patients (52.8%), subtherapeutic in 20 (28.6%), and supratherapeutic in 13 (18.6%). Adverse effects were reported in six (8.6%) patients. SOFA score was identified as a factor associated with an increase in voriconazole concentration (p = 0.025), mainly in the group of patients who had SOFA score ≥ 10. Moreover, an increase in voriconazole concentration was shown to be a risk factor for occurrence of adverse effects (p = 0.011). In that respect, critically ill patients who received voriconazole treatment must benefit from a TDM, particularly if they have a SOFA score ≥ 10. Indeed, identifying patients who are overdosed will help to prevent voriconazole related adverse effects. This result is of utmost importance given the recognized COVID-19-associated pulmonary aspergillosis in ICU patients for whom voriconazole is among the recommended first-line treatment.Anne-Lise BienvenuPierre PradatAlexandra PlesaVincent LeclercVincent PiriouJean-Luc FellahiLaurent ArgaudThomas RimmeléJean MenottiFrédéric AubrunJean-Christophe RichardMarie-Claude GagnieuFrançois ParantChristian ChidiacGilles LeboucherMichel TodSylvain GoutellePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0260656 (2021) |
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DOAJ |
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Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Anne-Lise Bienvenu Pierre Pradat Alexandra Plesa Vincent Leclerc Vincent Piriou Jean-Luc Fellahi Laurent Argaud Thomas Rimmelé Jean Menotti Frédéric Aubrun Jean-Christophe Richard Marie-Claude Gagnieu François Parant Christian Chidiac Gilles Leboucher Michel Tod Sylvain Goutelle Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| description |
Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patients and evaluating the impact of voriconazole concentrations on adverse effects. A 2-year retrospective multicenter cohort study (NCT04502771) was conducted in six intensive care units. Adult patients who had at least one voriconazole TDM were included. Univariable and multivariable linear regression analyses were performed to identify predictors of voriconazole concentrations, and univariable logistic regression analysis, to study the relationship between voriconazole concentrations and adverse effects. During the 2-year study period, 70 patients were included. Optimal trough voriconazole concentrations were reported in 37 patients (52.8%), subtherapeutic in 20 (28.6%), and supratherapeutic in 13 (18.6%). Adverse effects were reported in six (8.6%) patients. SOFA score was identified as a factor associated with an increase in voriconazole concentration (p = 0.025), mainly in the group of patients who had SOFA score ≥ 10. Moreover, an increase in voriconazole concentration was shown to be a risk factor for occurrence of adverse effects (p = 0.011). In that respect, critically ill patients who received voriconazole treatment must benefit from a TDM, particularly if they have a SOFA score ≥ 10. Indeed, identifying patients who are overdosed will help to prevent voriconazole related adverse effects. This result is of utmost importance given the recognized COVID-19-associated pulmonary aspergillosis in ICU patients for whom voriconazole is among the recommended first-line treatment. |
| format |
article |
| author |
Anne-Lise Bienvenu Pierre Pradat Alexandra Plesa Vincent Leclerc Vincent Piriou Jean-Luc Fellahi Laurent Argaud Thomas Rimmelé Jean Menotti Frédéric Aubrun Jean-Christophe Richard Marie-Claude Gagnieu François Parant Christian Chidiac Gilles Leboucher Michel Tod Sylvain Goutelle |
| author_facet |
Anne-Lise Bienvenu Pierre Pradat Alexandra Plesa Vincent Leclerc Vincent Piriou Jean-Luc Fellahi Laurent Argaud Thomas Rimmelé Jean Menotti Frédéric Aubrun Jean-Christophe Richard Marie-Claude Gagnieu François Parant Christian Chidiac Gilles Leboucher Michel Tod Sylvain Goutelle |
| author_sort |
Anne-Lise Bienvenu |
| title |
Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| title_short |
Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| title_full |
Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| title_fullStr |
Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| title_full_unstemmed |
Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients. |
| title_sort |
association between voriconazole exposure and sequential organ failure assessment (sofa) score in critically ill patients. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/cd0d8eced2204a44936cdb5b3a8cd8c5 |
| work_keys_str_mv |
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