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Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy and haemopoietic stem cell transplant recipients, 2021.
Chau, Maggie M; Daveson, Kathryn; Alffenaar, Jan-Willem C; Gwee, Amanda; Ho, Su Ann; Marriott, Deborah J E; Trubiano, Jason A; Zhao, Jessie; Roberts, Jason A.
Afiliación
  • Chau MM; Pharmacy Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
  • Daveson K; Department of Infectious Diseases and Microbiology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
  • Alffenaar JC; Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia.
  • Gwee A; Pharmacy Department, Westmead Hospital, Westmead, New South Wales, Australia.
  • Ho SA; Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia.
  • Marriott DJE; Infectious Diseases Unit, The Royal Children's Hospital, Parkville, Victoria, Australia.
  • Trubiano JA; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
  • Zhao J; Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
  • Roberts JA; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Intern Med J ; 51 Suppl 7: 37-66, 2021 Nov.
Article en En | MEDLINE | ID: mdl-34937141
Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. Suboptimal dosing can be minimised by clinical assessment, laboratory monitoring, avoidance of interacting drugs, and dose modification. Therapeutic drug monitoring (TDM) plays an increasingly important role in antifungal therapy, particularly for antifungal agents that have an established exposure-response relationship with either a narrow therapeutic window, large dose-exposure variability, cytochrome P450 gene polymorphism affecting drug metabolism, the presence of antifungal drug interactions or unexpected toxicity, and/or concerns for non-compliance or inadequate absorption of oral antifungals. These guidelines provide recommendations on antifungal drug monitoring and TDM-guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Intern Med J Asunto de la revista: MEDICINA INTERNA Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Intern Med J Asunto de la revista: MEDICINA INTERNA Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia