USE OF NEBULIZED VORICONAZOLE: A SINGLE-CENTER REAL-LIVE STUDY

Le résumé fourni par la source

Voriconazole is the primary treatment for invasive pulmonary aspergillosis (IPA) and it has been used to treat patients colonized by Aspergillus spp. The pulmonary route could increase drug concentration in the biophase, reduce drug-drug interactions (DDI) and minimize adverse events (AE); however, there is scarce evidence about its use and there are no commercial voriconazole formulations for nebulization. The goal of this study is to characterize the compounded voriconazole solution for nebulization and describe its use in our center. This is a retrospective observational study including all patients treated with nebulized voriconazole to treat pulmonary fungal infections or colonizations. Voriconazole solution was prepared from commercial vials for intravenous administration. The pH and osmolarity of voriconazole solutions were adequate for nebulization, the dosage was 40 mg in adults and 10mg in the paediatric patient, administered every 12-24h. The median duration of treatment was 139 (26-911) days, there were no reported adverse effects related to voriconazole nebulization and the drug was not detected in plasma when used through the pulmonary route only. There were 3 cases of death, one case of voriconazole resistance, 3 cases of microbiological response, 2 cases of colonization without exacerbation and one case of successful prophylaxis. Voriconazole nebulization is well-tolerated and the drug is not absorbed into the systemic circulation. Further research is needed to assess voriconazole nebulization efficacy in specific clinical situations.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.