Voriconazole: a new triazole antifungal

OBJECTIVE: To review the currently available information on the pharmacology, pharmacokinetics, efficacy, adverse effects, drug interactions, and dosage guidelines of voriconazole. Comparative data for voriconazole and other azole antifungal agents are described where available. DATA SOURCES: A MEDLINE search restricted to English-language articles (1966 to September 1999) was conducted, and an extensive review of journals and meeting abstracts was performed. MeSH headings included itraconazole, fluconazole, voriconazole, UK-109,496, and amphotericin B. DATA EXTRACTION: The data on pharmacokinetics, adverse effects, and drug interactions were obtained from open-label and controlled studies and case reports. Controlled studies and case reports were evaluated to demonstrate the efficacy of voriconazole in treatment of various fungal infections. DATA SYNTHESIS: Voriconazole is a derivative of fluconazole that demonstrates enhanced in vitro activity against existent and emerging fungal pathogens. Limited data have revealed a favorable pharmacokinetic and safety profile for the agent. Moreover, select clinical trials and case studies of voriconazole suggest good in vivo efficacy against several fungal pathogens including Candida, Aspergillus, and Scedosporium. CONCLUSIONS: Voriconazole has shown promise in the treatment of superficial and systemic mycoses. While several unresolved issues remain, voriconazole may be a viable therapeutic alternative for fluconazole-resistant mucocutaneous candidiasis and in cases of mild to moderate systemic mycoses requiring chronic treatment or that are refractory to currently available agents.

This article has been cited by other articles:

				S M Hariprasad, W F Mieler, T K Lin, W E Sponsel, and J R Graybill Voriconazole in the treatment of fungal eye infections: a review of current literature Br. J. Ophthalmol., July 1, 2008; 92(7): 871 - 878. [Abstract] [Full Text] [PDF]

				G. A. Vemulakonda, S. M. Hariprasad, W. F. Mieler, R. A. Prince, G. K. Shah, and R. N. Van Gelder Aqueous and Vitreous Concentrations Following Topical Administration of 1% Voriconazole in Humans Arch Ophthalmol, January 1, 2008; 126(1): 18 - 22. [Abstract] [Full Text] [PDF]

				Y.-C. Shen, M.-Y. Wang, C.-Y. Wang, T.-C. Tsai, H.-Y. Tsai, Y.-F. Lee, and L.-C. Wei Clearance of Intravitreal Voriconazole Invest. Ophthalmol. Vis. Sci., May 1, 2007; 48(5): 2238 - 2241. [Abstract] [Full Text] [PDF]

				M. A. Pfaller, L. Boyken, R. J. Hollis, S. A. Messer, S. Tendolkar, and D. J. Diekema In Vitro Susceptibilities of Clinical Isolates of Candida Species, Cryptococcus neoformans, and Aspergillus Species to Itraconazole: Global Survey of 9,359 Isolates Tested by Clinical and Laboratory Standards Institute Broth Microdilution Methods J. Clin. Microbiol., August 1, 2005; 43(8): 3807 - 3810. [Abstract] [Full Text] [PDF]

				H. Gao, M. E. Pennesi, K. Shah, X. Qiao, S. M. Hariprasad, W. F. Mieler, S. M. Wu, and E. R. Holz Intravitreal Voriconazole: An Electroretinographic and Histopathologic Study Arch Ophthalmol, November 1, 2004; 122(11): 1687 - 1692. [Abstract] [Full Text] [PDF]

				S. M. Hariprasad, W. F. Mieler, E. R. Holz, H. Gao, J. E. Kim, J. Chi, and R. A. Prince Determination of Vitreous, Aqueous, and Plasma Concentration of Orally Administered Voriconazole in Humans Arch Ophthalmol, January 1, 2004; 122(1): 42 - 47. [Abstract] [Full Text] [PDF]

				E. R. Dabbs, S. Naidoo, C. Lephoto, and N. Nikitina Pathogenic Nocardia, Rhodococcus, and Related Organisms Are Highly Susceptible to Imidazole Antifungals Antimicrob. Agents Chemother., April 1, 2003; 47(4): 1476 - 1478. [Abstract] [Full Text] [PDF]

				M. M Pearson, P D. Rogers, J. D Cleary, and S. W Chapman Voriconazole: A New Triazole Antifungal Agent Ann. Pharmacother., March 1, 2003; 37(3): 420 - 432. [Abstract] [Full Text] [PDF]

				M. A. Pfaller, D. J. Diekema, S. A. Messer, L. Boyken, R. J. Hollis, and R. N. Jones In Vitro Activities of Voriconazole, Posaconazole, and Four Licensed Systemic Antifungal Agents against Candida Species Infrequently Isolated from Blood J. Clin. Microbiol., January 1, 2003; 41(1): 78 - 83. [Abstract] [Full Text] [PDF]

				M. J. Maxwell, S. A. Messer, R. J. Hollis, D. J. Diekema, and M. A. Pfaller Evaluation of Etest Method for Determining Voriconazole and Amphotericin B MICs for 162 Clinical Isolates of Cryptococcus neoformans J. Clin. Microbiol., January 1, 2003; 41(1): 97 - 99. [Abstract] [Full Text] [PDF]

				S. A Pacetti and S. P Gelone Caspofungin Acetate for Treatment of Invasive Fungal Infections Ann. Pharmacother., January 1, 2003; 37(1): 90 - 98. [Abstract] [Full Text] [PDF]

				M. A. Pfaller, S. A. Messer, R. J. Hollis, R. N. Jones, and D. J. Diekema In Vitro Activities of Ravuconazole and Voriconazole Compared with Those of Four Approved Systemic Antifungal Agents against 6,970 Clinical Isolates of Candida spp. Antimicrob. Agents Chemother., June 1, 2002; 46(6): 1723 - 1727. [Abstract] [Full Text] [PDF]

				C. Mactal-Haaf, M. Hoffman, and A. Kuchta Use of Anti-Infective Agents During Lactation, Part 3: Antivirals, Antifungals, and Urinary Antiseptics J Hum Lact, May 1, 2001; 17(2): 160 - 166. [Abstract] [PDF]