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Disposition of voriconazole during continuous veno-venous haemodiafiltration (CVVHDF) in a single patient.

OBJECTIVES
To determine whether voriconazole dosage adjustment is required during continuous veno-venous haemodiafiltration (CVVHDF).


METHODS
Voriconazole pharmacokinetics were studied in a critically ill patient under CVVHDF. The analysis was carried out for 12 h following a 6 mg/kg dose. Voriconazole concentrations were measured by HPLC in blood inlet and outlet lines and in dialysate.


RESULTS
The total body clearance of voriconazole was 20.3 L/h, with a terminal half-life of 13.7 h and a distribution volume of 399 L. The estimated sieving coefficient was 0.53 and the filtration-dialysis clearance 1.2 L/h.


CONCLUSIONS
CVVHDF does not significantly affect voriconazole disposition and requires no dosage adjustment.