Research Progress of therapeutic drug monitoring of voriconazole in pediatric patients

Voriconazole has a nonlinear pharmacokinetic profile with wide inter- and intra-individual varieties in adults, polymorphisms and drug-drug interactions complicate treatment since it is extensively metabolized by the liver. Therefore, therapeutic drug monitoring plays an important role in clinical practice of voriconazole. Compared with that in adults, the pharmacokinetic behavior of voriconazole in pediatric patients is more complicated. However, the data are limited so the target range of voriconazole concentration and recommendations for dose adjustments of voriconazole have not been well described for a large cohort of pediatric patients, which indicates that these patients might be at higher risk. This article analyzes the research progress of voriconazole therapeutic drug monitoring in pediatric patients from three aspects:the necessity of therapeutic drug monitoring, monitoring strategy, and dose adjustment strategy, in order to provide a reference for clinical antifungal infection treatment in pediatric patients.