Project Details

Optimizing Voriconazole Therapy Using Model-Informed Precision Dosing

Mark Murphy, DO

Summary

BACKGROUND: Invasive fungal infections (IFI) are a life threatening infection with a mortality rate as high 50%. Voriconazole is an effective first line treatment for IFI when appropriate drug exposures are reached. Unfortunately, voriconazole exhibits significant pharmacokinetic variability leading to delay in targeted exposure in over 60% of pediatric patients. A novel approach to optimize pediatric dosing of voriconazole is pharmacokinetic/pharmacodynamic model informed precision dosing (MIPD) GAP: Model informed precision dosing utilizes statistical software and patient data to provide precision dosing for each individual patient. While MIPD has been successfully used with other difficult to dose drugs, it is currently unknown what the optimal sampling strategy to predict voriconazole drug exposure. HYPOTHESIS: We hypothesize MIPD of voriconazole will effectively predict steady-state voriconazole drug exposure and will improve time to appropriate therapy compared to current standard of care practices. METHODS: We will perform a prospective observational study to identify optimal sampling times that predicts steady-state voriconazole drug exposure. A follow up study will be a prospective interventional study implementing MIPD to improve time to appropriate therapy. RESULTS: Pending. IMPACT: The findings from this proposal will support model informed precision dosing of voriconazole in pediatrics. Additionally, these findings will demonstrate this approach can be utilized in other difficult to dose drugs. Website Link: https://www.cincinnatichildrens.org/bio/m/mark-murphy