| Title | Voriconazole use and pharmacokinetics in combination with interferon-gamma for refractory cryptococcal meningitis in a patient receiving low-dose ritonavir. | | Author(s) | Nierenberg NE, Thompson GR, Lewis JS, Hogan BK, Patterson TF | | Institution | Departments of Internal Medicine, Division of General Medicine. | | Source | Med Mycol 2009 Oct 19. | | Abstract | We present a case of relapsing cryptococcal meningitis unresponsive to standard therapy. Voriconazole induction, including the utilization of voriconazole therapeutic drug monitoring in both serum and CSF, with transition to voriconazole plus interferon-gamma (IFN-G) was successfully used in a patient receiving antiretroviral therapy with abacavir/ lamivudine and lopinavir/ritonavir. Initial voriconazole levels at standard doses of 4 mg/ kg twice daily intravenously were low when co-administered with lopinavir/ritonavir but increased to recommended therapeutic levels with an increase of the voriconazole dose to 7 mg/kg twice daily. This case highlights the utility of voriconazole therapeutic drug monitoring when prescribed concurrently with a ritonavir boosted protease inhibitor and the potential role of combination therapy with IFN-G for refractory cryptococcal meningitis. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19835489 |
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