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-γ) 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-γ for refractory cryptococcal meningitis.
Original language | English (US) |
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Pages (from-to) | 532-536 |
Number of pages | 5 |
Journal | Medical mycology |
Volume | 48 |
Issue number | 3 |
DOIs | |
State | Published - 2010 |
Keywords
- Cryptococcus
- Salvage
- Therapeutic drug monitoring
- Voriconazole
ASJC Scopus subject areas
- Infectious Diseases