Valganciclovir—Ganciclovir Use and Systematic Therapeutic Drug Monitoring. An Invitation to Antiviral Stewardship

Valganciclovir (VGCV) and ganciclovir (GCV) doses must be adjusted according to indication, renal function weight. No specific therapeutic exposure values have been established. We aimed evaluate the adequacy of VGCV/GCV doses, assess interpatient variability in GCV serum levels, identify predictive factors for this clinical impact. This is a prospective study at tertiary institution including hospitalized patients receiving prophylaxis or treatment. Adequacy antiviral dose was defined cytomegalovirus guidelines. Serum levels were determined using High-Performance Liquid Chromatography. Blood samples drawn least 3 days after initiation. Outcome considered favorable if there no evidence infection during when microbiological resolution attained within 21 treatment need drug discontinuation due toxicity. Seventy consecutive [74.3% male/median age: 59.2 years] included. VGCV used 25 (35.7%) 45 (64.3%). initial dosage deemed adequate 47/70 cases (67.1%), lower than recommended 7/70 (10%) higher 16/70 (22.9%). Large inter-individual observed, with median trough 2.3 mg/L peak 7.8 mg/L. Inadequate dosing 8.37 greater 11.86 related poor outcome. Further studies performed confirm these results conclusively establish monitoring could useful improve outcomes situations.