CJIDMM Canadian Journal of Infectious Diseases and Medical Microbiology 1712-9532 Pulsus Group Inc 34058610.1155/2014/340586 Review Therapeutic drug monitoring for triazoles: A needs assessment review and recommendations from a Canadian perspective Laverdiere Michel michel.laverdiere@umontreal.ca 1 Bow Eric J 2 Rotstein Coleman 3 Autmizguine Julie 4 5 Broady Raewyn 6 Garber Gary 7 Haider Shariq 8 Hussaini Trana 9 Husain Shahid 3 Ovetchkine Philippe 10 Seki Jack T 11 12 Théorêt Yves 5 13 1 Department of Microbiology and Infectious Diseases Hôpital Maisonneuve-Rosemont Montreal Quebec Canada maisonneuve-rosemont.org 2 Departments of Medical Microbiology and Infectious Diseases and Internal Medicine Sections of Infectious Diseases and Hematology∕Oncology Blood and Marrow Transplant University of Manitoba Winnipeg Manitoba Canada umanitoba.ca 3 Division of Infectious Diseases Toronto General Hospital University Health Network University of Toronto Toronto Ontario Canada utoronto.ca 4 Service des Maladies Infectieuses Département de Pédiatrie Canada 5 Unité de Pharmacologie Clinique CHU Ste-Justine Montreal Quebec Canada chusj.org 6 Division of Haematology University of British Columbia Vancouver British Columbia Canada ubc.ca 7 Division of Infectious Diseases University of Ottawa∕Ottawa Hospital Canada 8 Hamilton Health Sciences McMaster University Hamilton Ontario Canada mcmaster.ca 9 Solid Organ Transplantation Pharmaceutical Sciences Clinical Service Unit Vancouver General Hospital Vancouver British Columbia Canada vch.ca 10 Service de Maladies Infectieuses Département de Pédiatrie CHU Sainte-Justine Université de Montréal Montreal Canada umontreal.ca 11 Department of Pharmacy Princess Margaret Cancer Centre University Health Network Canada theprincessmargaret.ca 12 Leslie Dan Faculty of Pharmacy University of Toronto Toronto Ontario Canada utoronto.ca 13 Département de Pharmacologie Université de Montréal Montreal Quebec Canada umontreal.ca 2014 25 6 327 343 2014 Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Invasive fungal infections cause significant morbidity and mortality in patients with concomitant underlying immunosuppressive diseases. The recent addition of new triazoles to the antifungal armamentarium has allowed for extended-spectrum activity and flexibility of administration. Over the years, clinical use has raised concerns about the degree of drug exposure following standard approved drug dosing, questioning the need for therapeutic drug monitoring (TDM). Accordingly, the present guidelines focus on TDM of triazole antifungal agents. A review of the rationale for triazole TDM, the targeted patient populations and available laboratory methods, as well as practical recommendations based on current evidence from an extended literature review are provided in the present document.

Invasive fungal infection Therapeutic drug monitoring Triazole antifungal antibiotics