Voriconazole MIC

Laboratory assay overview

This test determines susceptibility of a rapidly growing and non-fastidious yeast isolate to a comprehensive set of antifungal agents. This test is performed on pure yeast isolates including Candida and Cryptococcus to aid in patient management. The susceptibility of a yeast isolate is measured by determining the minimum inhibitory concentration (MIC), which is the lowest drug concentration that prevents growth. An isolate can be categorized as susceptible, intermediate, susceptible-dose dependent, or resistant by comparing the MIC of an isolate to established clinical breakpoints [1]. MIC interpretations are based on recently published guidelines from the Clinical and Laboratory Standards Institute (CLSI). When a clinical breakpoint for an antifungal agent is not established by CLSI guidelines, only the MIC value is reported. For additional guidance, please review current CLSI documents related to antifungal susceptibility testing of yeasts. Because treatment outcomes are influenced by many factors (eg, drug pharmacokinetics, pharmacodynamics, and interactions; the patient's immune response; disease severity), a "susceptible" or a "resistant" result does not ensure that a patient will or will not respond to a particular drug. Invasive yeast infections, commonly caused by Candida and Cryptococcus, are associated with significant morbidity and mortality especially in immunocompromised individuals [2,3]. Species of these organisms have unique virulence and antifungal susceptibility. A particular species can be resistant to some antifungal agents and susceptible to others. Therefore, species identification and antifungal susceptibility testing can help guide treatment decisions for invasive infections [4]. Yeast susceptibility testing is useful when a yeast's identity does not reliably predict its susceptibility, particularly when the identified yeast belongs to a species known to resist common antifungal agents [1]. The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings. References 1. CLSI. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. 4th ed. CLSI guideline M27. Clinical and Laboratory Standards Institute; 2017. 2. Invasive candidiasis statistics. Centers for Disease Control and Prevention. Updated August 24, 2021. Accessed February 7, 2022. https://www.cdc.gov/fungal/diseases/candidiasis/invasive/statistics.html 3. C. neoformans Infection Statistics. Centers for Disease Control and Prevention. Updated May 26, 2020. Accessed February 7, 2022. https://www.cdc.gov/fungal/diseases/cryptococcosis-neoformans/statistics.html 4. Pappas PG, et al. Clin Infect Dis. 2016;62(4):e1-e50.

Laboratory assay overview

The antifungal drug voriconazole is commonly used in the treatment of various types of fungal infections. An increased fungal resistance to similar drugs of greater toxicity has promoted the use of voriconazole in treating infections caused by aspergillus and other fungal species. The chronic nature of fungal infections demands constant monitoring of voriconazole levels within a patient to ensure that adequate therapeutic levels of the drug are administered, absorbed and subsequently excreted.

Laboratory assay overview

Treatment of invasive aspergillosis; treatment of esophageal candidiasis; treatment of candidemia; treatment of candida deep tissue infections; treatment of serious fungal infections caused by Scedosporium apiospermum and fusarium spp in patients intolerant or refractory to other therapy.

Laboratory assay overview

This test is used to determine the susceptibility of Candida isolates to antifungal agents. Interpretive criteria are provided for certain organism/drug combinations based on clinical data from infections with Candida spp. Note that the intermediate category when utilized provides a buffer zone to limit errors associated with inherent variability in the test method. Strains with intermediate MICs might respond clinically to a higher-than-standard dose of a drug or in situations in which drug penetration is maximized.

Laboratory assay overview

This test is used to determine the susceptibility of yeast isolates to antifungal agents. Interpretive criteria are provided for certain organism/drug combinations based on clinical data from infections with Candida spp. Note that the intermediate category provides a buffer zone to limit errors associated with inherent variability in the test method. Strains with intermediate MICs might respond clinically to a higher-than-standard dose of a drug or in situations in which drug penetration is maximized.