The impact of an antifungal stewardship team on voriconazole therapeutic drug monitoring in a UK tertiary hospital

In this Journal Schelenz and colleagues reported that only 71% of laboratories in the UK provided advice on voriconazole therapeutic drug monitoring (TDM)[1]. It also highlighted issues of when and on whom to perform it.1 Voriconazole is a triazole antifungal agent licensed for the prevention and treatment of invasive aspergillosis. TDM is recommended due to its non-linear pharmacokinetics and genetic polymorphisms affecting metabolism, leading to unpredictable plasma levels.2,3 A systematic review highlighted the importance of voriconazole TDM with respect to drug efficacy and safety.