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. 2024 Sep;54(6):104955.
doi: 10.1016/j.idnow.2024.104955. Epub 2024 Jul 21.

Voriconazole as an alternative oral treatment in fluconazole-resistant urinary candidiasis

Christelle Boglione-Kerrien  1 , Audrey Le Bot  2 , David Luque Paz  2 , Marie-Clémence Verdier  3 , Hélène Guegan  4 , Jean-Pierre Gangneux  4 , Eric Bellissant  3 , Florian Lemaitre  3
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Free article

Voriconazole as an alternative oral treatment in fluconazole-resistant urinary candidiasis

Christelle Boglione-Kerrien et al. Infect Dis Now. 2024 Sep.
Free article

Abstract

Objectives: This study aims to assess the urinary diffusion and clinical effectiveness of voriconazole in patients with fluconazole-resistant urinary candidiasis.

Patients and methods: In this prospective pilot study, we utilized a validated chromatography method to measure voriconazole in urine over a 12-hour period between two administrations of the drug and in plasma at trough.

Results: Thirty-five patients, including five with fluconazole-resistant urinary candidiasis, were included. Urine and plasma voriconazole concentrations, mean 1.7 mg/L (range: 0.3-12.6) and mean 2.0 mg/L (range: 0.1-11.1) respectively, exhibited a strong correlation (R2 = 0.88). None of the five patients treated for candidiasis experienced clinical or microbiological failure following treatment, with urine concentrations ranging from 0.5 to 2.7 mg/L.

Conclusions: The urinary diffusion of voriconazole resulted in drug exposure above the target minimum inhibitory concentration (MIC) in the five patients treated for voriconazole-susceptible Candida strains in urine. Therapeutic drug monitoring may allow optimize in situ concentrations.

Keywords: Antifungal; Fluconazole-resistance; Therapeutic drug monitoring; Urinary candidiasis; Voriconazole.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [FL received research grants (paid to institution) from Astellas, Sandoz and Chiesi and fees to attend meetings from Viiv, MSD, Janssen-Cilag, Pfizer and Gilead. JPG received honoraria for scientificsymposia in congresses from Gilead, MundiPharma, Shionogi and Pfizer. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper].

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