Year: 2011
Type: letter
Abstract: Sir: We appreciate Dr Yong's interest in our article [1] and agree that voriconazole is an attractive option in the treatment of refractory cryptococcosis. Our case sought to emphasize the importance of therapeutic drug monitoring (TDM) and pharmacokinetic assessment when voriconazole is co-administered with ritonavir and to describe the use of IFN-γ in the treatment of refractory cryptococcosis. The case reports listed by Dr Yong are illustrative of the potential efficacy of voriconazole in the treatment of cryptococcosis. However, they may be subject to reporting bias and may not accurately capture the overall efficacy of what remains a salvage regimen. In vitro and murine models of cryptococcal meningitis have, in fact, shown the potential efficacy of voriconazole, yet the efficacy observed in the largest description of the use of voriconazole in the treatment of invasive cryptococcosis was only 38.9% of all patients [2]. This low response rate was likely secondary to the high number of patients with concomitant AIDS and despite the low reported overall efficacy, 89% had stable disease and 94% were alive 90 days after the initiation of treatment.
Source: Medical Mycology
Authors: George R. Thompson, Thomas F. Patterson
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1985354966