Clinical pharmacology and therapeutic drug monitoring of voriconazole

More and more attention is paid to personalised medicine. For some drugs, the drug concentration in the blood can be measured to improve treatment with this drug. Voriconazole is a drug that is widely used for severe fungal infections in for instance the lungs. For voriconazole, several guidelines recommend that the voriconazole concentration in blood should be monitored regularly. In this thesis is therefore investigated whether measuring  voriconazole concentrations indeed results in an improved treatment with this drug. The results show that solely measuring the voriconazole blood concentration is not sufficient to optimise treatment with this drug, but that it must be part of a multidisciplinary approach. In addition, in this thesis is investigated which factors influence the amount of voriconazole that eventually receives the bloodstream. Among others, these studies showed that degradation of voriconazole is reduced during an infection. Furthermore, we have described why it is useful to measure the degradation product of voriconazole in addition to voriconazole, because it could contribute to personalised medicine with the aim to reduce side effects and optimise treatment. In addition we have provided practical tools to improve voriconazole treatment in clinical practice.

Proefschrift: http://hdl.handle.net/11370/12edf571-0f9c-4a2b-a17f-adf7749b467d