Association between trough plasma voriconazole concentration and adverse drug reactions in elderly patients.

Abstract

Only limited data are available on trough plasma voriconazole concentration in elderly patients. This study aimed to assess the association between voriconazole concentration and adverse drug reactions (ADR). A retrospective analysis was conducted to investigate the correlation between voriconazole trough concentration and adverse reactions among elderly patients admitted between October 1, 2017, and September 30, 2020. In total 147 patients were included in this study, with 248 measurements of voriconazole concentrations available. ADR occurred in 75 patients after drug therapy, with liver injury showing the highest incidence (n = 37, 49.33%), followed by hypokalemia (n = 27, 36%), and neurological disorder (n = 20, 26.67%). 121 measurements (48.79%) in 82 patients (55.78%) showed that the monitored trough concentration did not match the occurrence of ADR, mainly including hyponatremia, hypokalemia, liver injury, and kidney injury. The accuracy of predicting the trough concentration of voriconazole as recommended by current guidelines for elderly patients might be limited. Consequently, it is advisable to establish a tailored treatment range of voriconazole concentration specifically catered to this patient demographic.