RT Journal Article
T1 Valganciclovir—Ganciclovir Use and Systematic Therapeutic Drug Monitoring. An Invitation to Antiviral Stewardship
A1 Galar, Alicia
A1 Valerio, Maricela
A1 Catalán Alonso, Pilar
A1 García González, Xandra
A1 Burillo Albizua, Almudena
A1 Fernández Cruz, Ana
A1 Zataráin, Eduardo
A1 Sousa Casasnovas, Iago
A1 Anaya, Fernando
A1 Rodríguez Ferrero, María
A1 Muñoz García, Patricia Carmen
A1 Bouza, Emilio
AB Valganciclovir (VGCV) and ganciclovir (GCV) doses must be adjusted according to indication, renal function and weight. No specific therapeutic exposure values have been established. We aimed to evaluate the adequacy of VGCV/GCV doses, to assess the interpatient variability in GCV serum levels, to identify predictive factors for this variability and to assess the clinical impact. This is a prospective study at a tertiary institution including hospitalized patients receiving VGCV/GCV prophylaxis or treatment. Adequacy of the antiviral dose was defined according to cytomegalovirus guidelines. Serum levels were determined using High-Performance Liquid Chromatography. Blood samples were drawn at least 3 days after antiviral initiation. Outcome was considered favorable if there was no evidence of cytomegalovirus infection during prophylaxis or when a clinical and microbiological resolution was attained within 21 days of treatment and no need for drug discontinuation due to toxicity. Seventy consecutive patients [74.3% male/median age: 59.2 years] were included. VGCV was used in 25 patients (35.7%) and GCV in 45 (64.3%). VGCV/GCV initial dosage was deemed adequate in 47/70 cases (67.1%), lower than recommended in 7/70 (10%) and higher in 16/70 (22.9%). Large inter-individual variability of serum levels was observed, with median trough levels of 2.3 mg/L and median peak levels of 7.8 mg/L. Inadequate dosing of VGCV/GCV and peak levels lower than 8.37 or greater than 11.86 mg/L were related to poor outcome. Further studies must be performed to confirm these results and to conclusively establish if VGCV/GCV therapeutic drug monitoring could be useful to improve outcomes in specific clinical situations.
PB MPDI
SN 2079-6382
YR 2021
FD 2021-01-15
LK https://hdl.handle.net/20.500.14352/8698
UL https://hdl.handle.net/20.500.14352/8698
LA eng
NO Galar, A., Valerio, M., Catalán, P. et al. «Valganciclovir—Ganciclovir Use and Systematic Therapeutic Drug Monitoring. An Invitation to Antiviral Stewardship». Antibiotics, vol. 10, n.o 1, enero de 2021, p. 77. DOI.org (Crossref), https://doi.org/10.3390/antibiotics10010077.
NO Instituto de Salud Carlos III/Fondo Europeo de Desarrollo Regional
DS Docta Complutense
RD 9 may 2025