Voriconazole use and pharmacokinetics in combination with interferon-γ for refractory cryptococcal meningitis in a patient receiving low-dose ritonavir

Natalie E. Nierenberg, George R. Thompson, James S. Lewis, Brian K. Hogan, Thomas F. Patterson

Research output: Contribution to journalArticle

16 Scopus citations

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 languageEnglish (US)
Pages (from-to)532-536
Number of pages5
JournalMedical mycology
Volume48
Issue number3
DOIs
StatePublished - 2010
Externally publishedYes

Keywords

  • Cryptococcus
  • Salvage
  • Therapeutic drug monitoring
  • Voriconazole

ASJC Scopus subject areas

  • Infectious Diseases

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