Therapeutic Drug Monitoring of Ganciclovir: A Path Worth Exploring

Highly variable exposure to ganciclovir with standard dosing suggests the importance of therapeutic drug monitoring to reduce myelotoxicity and emergence of resistance.

Cytomegalovirus (CMV) poses significant morbidity and mortality risks to recipients of stem-cell and solid-organ transplants. While ganciclovir (GCV) effectively reduces such risks, treatment-related adverse effects — especially myelotoxicity — significantly complicate use of this antiviral for CMV prophylaxis and therapy.

Märtson and colleagues performed an observational study in 95 transplant recipients of GCV or the prodrug valGCV who had routine therapeutic drug monitoring (TDM) of GCV to determine links between drug exposure (serum trough concentration [C_min] and 24-hr area under the curve [AUC₂₄] values) and drug toxicity. Approximately half of the cohort received either agent as prophylaxis and half as treatment. C_min and AUC₂₄ were m…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases