Evaluation and Pharmacy Care of Voriconazole Therapeutic Drug Monito-ring Exceeding the Recommended Treatment Concentration Threshold
OBJECTIVE Explore the reasons and pharmacy care mode of voriconazole therapeutic drug monito-ring exceeds the recommended treatment concentration threshold.METHODS Collect inpatients who underwent therapeutic drug monitoring of voriconazole in Zhongshan Hospital Affiliated to Xiamen University from January to December 2022,screen,organize,and analyze the reasons for the therapeutic drug monitoring of voriconazole excee-ding the recommended treatment concentration,as well as the pharmacy care of personalized medication recommenda-tions.RESULTS 131 out of 395 TDM with Cvcz＞5.5 μg·mL-1,involving 83 patients.There were 80 cases of pulmonary infection(96.39％),and other 3 cases(3.61％).In the voriconazole threshold evaluation,37(28.24％)adjustments were made to the dose,dosage form or drug manufacturer,32(24.43％)Drug interaction,12(9.16％)inappropriate blood sampling times,9(6.87％)abnormal liver function,28(21.37％)severe infections combined with multiple factors above,and 13(9.92％)unknown causes.13 out of 83 patients(15.66％)experi-enced adverse reactions.10 patients had improved ADR outcomes after treatment,while 3 patients had unknown ADR outcomes.CONCLUSION There are significant differences in the individualization of voriconazole.The pharmacy care mode of implementing TDM and conducting threshold warning management can help optimize individualized medication in clinical practice and improve the level of hospital pharmaceutical services.
VoriconazoleTherapeutic drug monitoringThresholdPharmacy carePersonalized medicineAdverse reactions
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