Experiencia sobre la utilización de voriconazol inhalado en un paciente pediátrico.

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Bibliographic Details
Title:	Experiencia sobre la utilización de voriconazol inhalado en un paciente pediátrico.
Authors:	García, M. Larrosa¹ mlarrosa@vhebron.net, Polo, A. Fernández¹, Teixidó, C. J. Parramón¹, Ramírez, C. Cañete¹
Source:	Farmacéutico Hospitales. mar2022, Issue 223, p30-34. 5p.
Abstract (English):	Voriconazole is a first-line agent used to treat pulmonary fungal infections; its administration via the nebulised route may bring a range of advantages, but there is little experience of its use by this route. The case presented here is that of a paediatric patient in receipt of a pulmonary transplant that is subsequently admitted to the Intensive Care Unit due to respiratory distress. Following isolation of Aspergillus flavus complex in bronchoalveolar aspirate, use of nebulised voriconazole in combination with intravenous antifungals was considered. For this purpose, physico-chemical characterisation of the voriconazole solution prepared from the commercial preparation for intravenous administration was performed. In this way, suitability of the agent for nebulised administration could be confirmed. Voriconazole was administered at a dose of 40 mg daily for 92 days; plasma concentrations of the drug were undetectable in the blood. In our experience, prolonged treatment with nebulised voriconazole was well-tolerated in our paediatric patient, and its systemic absorption was negligible. Further studies are needed in order to confirm its effectiveness for this indication. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Voriconazol es un tratamiento de primera línea para la infección fúngica pulmonar; su administración por vía nebulizada puede presentar numerosas ventajas, pero hay poca experiencia sobre su uso por esta vía. Se presenta el caso de un paciente pediátrico trasplantado pulmonar ingresado en la Unidad de Cuidados Intensivos por presentar dificultad respiratoria. Tras el aislamiento de la especie Aspergillus flavus complex en el aspirado broncoalveolar, se planteó el uso de voriconazol nebulizado en combinación con antifúngicos intravenosos. Para ello, se realizó la caracterización fisicoquímica de la disolución de voriconazol preparada a partir de la presentación comercial para administración intravenosa. De esta forma, se confirmó su idoneidad para la administración nebulizada. Se administraron 40 mg/día de voriconazol durante 92 días; las concentraciones plasmáticas del fármaco en sangre fueron indetectables. En nuestra experiencia, el tratamiento prolongado con voriconazol nebulizado fue bien tolerado en un paciente pediátrico, y su absorción sistémica fue irrelevante. Se requieren más estudios para confirmar su eficacia en esta indicación. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Voriconazole is a first-line agent used to treat pulmonary fungal infections; its administration via the nebulised route may bring a range of advantages, but there is little experience of its use by this route. The case presented here is that of a paediatric patient in receipt of a pulmonary transplant that is subsequently admitted to the Intensive Care Unit due to respiratory distress. Following isolation of Aspergillus flavus complex in bronchoalveolar aspirate, use of nebulised voriconazole in combination with intravenous antifungals was considered. For this purpose, physico-chemical characterisation of the voriconazole solution prepared from the commercial preparation for intravenous administration was performed. In this way, suitability of the agent for nebulised administration could be confirmed. Voriconazole was administered at a dose of 40 mg daily for 92 days; plasma concentrations of the drug were undetectable in the blood. In our experience, prolonged treatment with nebulised voriconazole was well-tolerated in our paediatric patient, and its systemic absorption was negligible. Further studies are needed in order to confirm its effectiveness for this indication. [ABSTRACT FROM AUTHOR]
ISSN:	02144697