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Therapeutic drug monitoring for triazoles: A needs assessment review and recommendations from a Canadian perspective
Authors:Michel Laverdiere  Eric J Bow  Coleman Rotstein  Julie Autmizguine  Raewyn Broady  Gary Garber  Shariq Haider  Trana Hussaini  Shahid Husain  Philippe Ovetchkine  Jack T Seki  Yves Théorêt
Abstract:Invasive fungal infections cause significant morbidity and mortality in patients with concomitant underlying immunosuppressive diseases. The recent addition of new triazoles to the antifungal armamentarium has allowed for extended-spectrum activity and flexibility of administration. Over the years, clinical use has raised concerns about the degree of drug exposure following standard approved drug dosing, questioning the need for therapeutic drug monitoring (TDM). Accordingly, the present guidelines focus on TDM of triazole antifungal agents. A review of the rationale for triazole TDM, the targeted patient populations and available laboratory methods, as well as practical recommendations based on current evidence from an extended literature review are provided in the present document.
Keywords:Invasive fungal infection   Therapeutic drug monitoring   Triazole antifungal antibiotics
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