64例儿童患者伏立康唑血药浓度监测数据回顾性分析OACSTPCD

Objective:To probe into the factors affecting the blood concentration of voriconazole and adverse drug reactions in children.Methods:Case data of children receiving voriconazole treatment and blood concentration monitoring in our hospital from Aug.2017 to Dec.2022 were retrospectively analyzed.Results:A total of 64 children were included,the blood concentration of voriconazole in 89 samples was 2.90(from 1.64 to 5.22)mg/L,64.04％of the drug levels were within therapeutic range.The administration dosage of voriconazole was positively related with trough concentration(r=0.417,P＜0.05).Different routes of administration and whether to combined with omeprazole,cyclosporine had significant difference on the blood concentration of voriconazole(P＜0.05).The main reported adverse drug reactions were electrolyte disturbance and hepatotoxicity.High trough concentration was the independent risk factors associated with hepatotoxicity of voriconazole.The area under the receiver operating characteristic(ROC)curve was 0.674 for hypohepatia.The cut-off values of voriconazole concentration was 1.92 mg/L for hepatotoxicity(with sensitivity of 87.1％,specificity of 50.0％).Conclusion:The blood concentration of voriconazole in children could be affected by many factors,the therapeutic drug monitoring is helpful to guide individualized therapy and ensure the safety and efficacy of voricaonazole in children.