Flucytosine therapeutic monitoring: 15 years experience from the UK

A. C. Pasqualotto, S. J. Howard, C. B. Moore, D. W. Denning

    Research output: Contribution to journalArticlepeer-review


    Background: There is uniform consensus that flucytosine blood concentrations should be measured to avoid toxicity and ensure adequate efficacy. Objectives and methods: The purpose of this study was to evaluate all flucytosine levels performed in a regional centre in the UK from October 1991 to May 2006. Concentrations were measured by bioassay. Results: We reviewed 1071 flucytosine levels in 233 patients, including 33 neonates. Overall, only 20.5% of levels were in the expected therapeutic range. Low levels were observed in 40.5%, of which 5.1% were undetectable levels (100 mg/L). High flucytosine levels occurred more frequently amongst neonates, which could be related to an immature renal system resulting in drug accumulation. Conclusions: Our findings reveal that the vast majority of patients were out of range for flucytosine levels. These data emphasize the importance of monitoring flucytosine levels. © The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
    Original languageEnglish
    Pages (from-to)791-793
    Number of pages2
    JournalJournal of Antimicrobial Chemotherapy
    Issue number4
    Publication statusPublished - Apr 2007


    • Bioassay
    • Candida
    • Cryptococcus
    • Drug monitoring


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