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PLEASE NOTE: Recent changes have been made to this Test


 Recent changes for Fluconazole

Recent changes for Fluconazole
DateFieldChanged FromChanged To
17th August 2020
Volume (Adults)

5 mL

3 mL

Minimum/Paediatric Volume

3 mL

Fluconazole

Laboratory:Clinical Biochemistry
Test Code:FLUCO
Specimen Types:Plasma
Container Types:
EDTA 10 mL
Adults Volume or Mass:3 mL
Minimum/Paediatric Volume or Mass:3 mL
Collection & Request Instructions:

Collect at steady state:Trough sample

Transport Instructions between Sites and/or Laboratories:Room Temperature
Assay Frequency:Weekly
Additional Notes:

A clear-cut therapeutic range has not been described. British guidelines (1) suggest the use of area under the curve (AUC- estimated from measurements at 1, 4 and 24 hours) over the minimal inhibitory concentration (MIC) of the organism and that >100 using the EUCAST method is associated with higher treatment success. A Brazilian study published recently describes serum levels between 20 and 40 mg/L in patients with neurocryptococcosis and that CSF levels correlate with serum levels. (2) Others (European Conference on Infections in Leukemia) suggest trough levels of > 10-15 mg/L as an alternative (see http://www.ecil-leukaemia.com/telechargements2015/ECIL6-Triazole-TDM-07-12-2015-Lewis-R-et-al.pdf ).

 

1. Ashbee HR et al. Therapeutic Drug Monitoring (TDM) of Antifungal Agents: Guidelines From the British Society for Medical Mycology. J Antimicrob Chemother. 2014 May;69(5):1162-76.  doi: 10.1093/jac/dkt508.  Epub 2013 Dec 29. 

2.Schiave LA, et al. Fluconazole levels in serum and cerebrospinal fluid according to daily dosage in patients with cryptococcosis and other fungal infections.  Braz J Infect Dis. 2018 Jan-Feb;22(1):11-15. doi: 10.1016/j.bjid.2017.10.003. Epub 2017 Nov 13.