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Antimicrob Agents Chemother. 2019 Jul 22. pii: AAC.01245-19. doi: 10.1128/AAC.01245-19. [Epub ahead of print]

Impact of triazole therapeutic drug monitoring availability and timing.

Author information

1
University of Wisconsin, Department of Pharmacy.
2
University of Wisconsin, Department of Medicine, Division of Infectious Diseases.
3
University of Wisconsin, Department of Pathology.
4
University of Wisconsin, Department of Medicine, Division of Infectious Diseases dra@medicine.wisc.edu.

Abstract

Therapeutic drug monitoring (TDM) is an established strategy to optimize antifungal therapy with certain triazoles. While established relationships exist between concentration and safety or efficacy, the impact of TDM timing on outcomes is unknown. We report clinical outcomes, including antifungal exposure and mortality, in patients receiving institutional versus reference laboratory TDM. The availability of in-house triazole assays reduced the time to drug concentration result (12h vs 68h, p<0.001), time to achieve therapeutic serum concentrations (10d vs 31d, p<0.001). Subtherapeutic concentrations were associated with higher patient mortality (32% vs 13.3%, p=0.036).

PMID:
31332058
DOI:
10.1128/AAC.01245-19

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