Vol.53 No.S-2 November 2005
Overview of Voriconazole
Division of Molecular & Clinical Microbiology, Department of Molecular Microbiology & Immunology,
Nagasaki University Graduate School of Medicine, 1-7-1 Sakamoto, Nagasaki, Japan
Abstract
Voriconazole (VRCZ) is a new triazole antifungal agent that was approved in Japan in April 2005. VRCZ is characterized by a high bioavailability and a broad spectrum of antifungal activity that includes a number of species that are refractory to other currently available antifungals, such as Candida glabrata and Candida krusei as well as Aspergillus, Fusarium, and Scedosporium species. VRCZ is available in both intravenous and oral formulations, facilitating a smooth switch from drip infusion to oral therapy. It shows excellent penetration into tissues that are sites of deep-seated mycoses, such as the lung, liver, kidney, brain and eyes. Although serum VRCZ concentrations may vary greatly, no correlation has been found between serum concentrations and efficacy or safety. For the treatment of deep-seated mycoses in patients with hematopoietic stem cell transplantation (HSCT), which is currently treated in Japan using fluconazole or amphotericin B, VRCZ is anticipated to be particularly effective for empiric and targeted therapy. A phase III clinical trial in Japan of VRCZ for the treatment of deep-seated mycoses showed that VRCZ was well tolerated and was extremely effective against aspergilloses, candidiasis, and cryptococcosis as well as against invasive pulmonary aspergillosis. An international trial of VRCZ and amphotericin B for the treatment of invasive aspergilloses that developed in immunocompromised patients after HSCT showed that VRCZ was significantly more effective. VRCZ promises to improve the treatment of deep-seated mycoses in Japan and is expected to exhibit excellent clinical effects in the future treatment of this condition.
Key word
voriconazole (VRCZ)
Received
July 8, 2005
Accepted
August 22, 2005
Jpn. J. Chemother. 53 (S-2): 1-3, 2005
