Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 4 1-2 2017 09 18 27 32 EN Hamidreza Taghvaye Masoumi Research Center for Rational Use of Drugs, and Clinical Pharmacy Department, Faculty of Pharmacy,Tehran University of Medical Sciences, Tehran, Iran Molouk Hadjibabaie Research Center for Rational Use of Drugs, and Clinical Pharmacy Department, Faculty of Pharmacy,Tehran University of Medical Sciences, Tehran, Iran Morvarid Zarif-Yeganeh Hematology-Oncology and SCT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2016 09 24 2016 12 18 Background: Invasive fungal infection is one of the most important causes of morbidity and mortality in pediatric patients undergoing Hematopoietic stem cell transplantation (HSCT). Voriconazole as a broad-spectrum anti-fungal agent which has been used widely for prevention and treatment of invasive fungal infections in immunocompromised patients. Alteration in voriconazole plasma concentrations may be resulted in lack of efficacy and some adverse effects. Methods: This observational cohort study assessed the therapeutic plasma concentration of voriconazole and its relationship with hepatotoxic adverse effect in pediatric patients undergoing HSCT. Plasma concentration of voriconazole was measured by High-performance liquid chromatography (HPLC) assay with technique extracted from Khoschsorur et al. Results: Among a total of 14 pediatric patients,5 patients received voriconazole orally and 9 patients received voriconazole intravenously. The median plasma concentration of voriconazole was 1.8 mcg/ml (range, 0.75-5.54 mcg/ml). There was no correlation between voriconazole dose and plasma concentration of voriconazole(p=0.166). Trough concentration of ≥ 4 mcg/ml was observed in 2 of 3 patients who experienced severe hepatic dysfunction. The plasma concentration of voriconazole did not significantly differ in patients with or without hepatotoxicity(p=0.406). Conclusions: Our study showed that trough levels of voriconazole were sub-therapeutic in 21.4% of children. Furthermore, hepatic enzyme abnormalities were observed in half of pediatric patients following voriconazole initiation during hospitalization. We didn’t find any correlation between plasma concentration of voriconazole and the incidence of hepatotoxicity. We also didn’t observe any correlation between voriconazole dose and plasma concentration of voriconazole, but the correlation was linear after exclusion of outlier data. https://jpc.tums.ac.ir/index.php/jpc/article/view/116 https://jpc.tums.ac.ir/index.php/jpc/article/download/116/97