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. 2007 Apr;59(4):791-3.
doi: 10.1093/jac/dkl550. Epub 2007 Mar 5.

Flucytosine therapeutic monitoring: 15 years experience from the UK

A C Pasqualotto  1 , S J Howard, C B Moore, D W Denning
Affiliations

Flucytosine therapeutic monitoring: 15 years experience from the UK

A C Pasqualotto et al. J Antimicrob Chemother. 2007 Apr.

Abstract

Background: There is uniform consensus that flucytosine blood concentrations should be measured to avoid toxicity and ensure adequate efficacy.

Objectives and methods: The purpose of this study was to evaluate all flucytosine levels performed in a regional centre in the UK from October 1991 to May 2006. Concentrations were measured by bioassay.

Results: We reviewed 1071 flucytosine levels in 233 patients, including 33 neonates. Overall, only 20.5% of levels were in the expected therapeutic range. Low levels were observed in 40.5%, of which 5.1% were undetectable levels (<12.5 mg/L). High levels occurred in 38.9%, of which 9.9% were considered potentially toxic (>100 mg/L). High flucytosine levels occurred more frequently amongst neonates, which could be related to an immature renal system resulting in drug accumulation.

Conclusions: Our findings reveal that the vast majority of patients were out of range for flucytosine levels. These data emphasize the importance of monitoring flucytosine levels.

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