Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis.

This study focuses on therapeutic drug monitoring of sputum voriconazole in pulmonary aspergillosis.. The research employs high-performance liquid chromatography (HPLC) techniques to address analytical challenges in the clinical field. Voriconazole is one of the most used antifungal azoles against pulmonary aspergillosis. Therapeutic drug monitoring (TDM) of the voriconazole concentration in plasma is recommended in clinical practice guidelines to prevent treatment failure and toxicity. The aim of this study was to evaluate the feasibility and utility of TDM of the... Research Background and Significance Pulmonary aspergillosis is a severe fungal infection primarily caused by Aspergillus species, posing significant treatment challenges especially in immunocompromised patients. Voriconazole, a second-generation triazole antifungal agent, is widely recognized as the first-line therapy for this condition due to its potent and broad-spectrum activity. However, voriconazole exhibits substantial inter- and intra-patient pharmacokinetic variability, necessitating therapeutic drug monitoring (TDM) to optimize dosing, enhance efficacy, and minimize toxicity. Traditionally, TDM is performed using plasma samples, but emerging data suggest that measuring voriconazole concentration directly in sputum could offer a more direct assessment of drug levels at the site of infection. This study addresses this clinical gap by developing and validating a high-performance liquid chromatography (HPLC) method tailored for quantifying voriconazole in sputum, thereby potentially improving individualized therapy and patient outcomes in pulmonary aspergillosis. Experimental Design and Methodology The study employed a rigorous analytical approach centered on HPLC to quantify voriconazole levels in s