Characterization and real-live results of nebulized voriconazole: A single-center observational study. / [Artículo traducido] Caracterización y resultados del uso de voriconazol nebulizado en un entorno real: un estudio observacional unicéntrico.

OBJECTIVE: Pulmonary administration of voriconazole involves advantages, including optimization of lung penetration and reduction of adverse effects and interactions. However, there is scarce evidence about its use and there are no commercial presentations for nebulization. We aim to characterize a compounded voriconazole solution for nebulization and describe its use in our center. METHOD: This is a retrospective observational study including patients who received nebulized voriconazole to treat fungal lung diseases (infection or colonization). Voriconazole solution was prepared from commercial vials for intravenous administration. RESULTS: The pH and osmolarity of voriconazole solutions were adequate for nebulization. Ten patients were included, nine adults and a child. The dosage was 40 mg in adults and 10 mg in the pediatric patient, diluted to a final concentration of 10 mg/ml, administered every 12-24 hours. The median duration of treatment was 139 (range: 26-911) days. There were no reported adverse effects and the drug was not detected in plasma when nebulized only. CONCLUSION: Voriconazole nebulization is well tolerated and it is not absorbed into the systemic circulation; further research is needed to assess its efficacy.

Physicochemical characterization of micafungin and anidulafungin for its nebulized administration.

OBJECTIVE: To determine by experimentation whether micafungin and  anidulafungin possess physicochemical properties suitable for  nebulization. METHOD: PH, osmolality, viscosity, density and chloride content were  determined by pH monitoring, osmometry, viscometry, densitometry  and potentiometry in two samples of different concentrations, 5 and 10  mg/mL each echinocandin. Results: The results obtained for micafungin solution were: pH 5.80 (0.14), osmolality 293.33 (1.53) mOsm/kg, chloride content  134.67 (0.58) mmol/L and density 1,009.4 (0,1) kg/m3; while for 10  mg/mL solution: osmolality 342.00 (1.00) mOsm/kg, chloride content  139.67 (0.58) mmol/L and density 1,014.5 (0.2) kg/m3. The results  obtained for 5 mg/mL anidulafungin were: pH 4.22 (0.01), osmolality  464.67 (2.52) mOsm/kg, chloride content 137.00 (0.00) mmol/L and  density 1,016.5 (0,2) kg/m3; while for 10 mg/mL solution: osmolality  656.33 (1.15) mOsm/kg, chloride content 132.00 (0.00) mmol/L and  density 1,029.8 (0.4) kg/m3. Conclusions: PH, osmolality, chloride content and density values  proved to be suitable for proper tolerability by nebulization.

Objetivo: Determinar experimentalmente si micafungina y  nidulafungina poseen propiedades fisicoquímicas adecuadas para su  nebulización.Método: Se determinó el pH, la osmolalidad, la viscosidad, la densidad y el contenido en cloruros mediante pH-metría, osmometría,  viscosimetría, densitometría y potenciometría, respectivamente, en dos  muestras de diferente concentración, 5 y 10 mg/ml, de cada  equinocandina.Resultados: Para la solución de micafungina 5 mg/ml los resultados  obtenidos fueron: pH 5,80 (0,14), osmolalidad 293,33 (1,53) mOsm/kg,  contenido en cloruros 134,67 (0,58) mmol/l y densidad  1.009,4 (0,1) kg/m3; y para la solución de 10 mg/ml: osmolalidad  342,00 (1,00) mOsm/kg, contenido en cloruros 139,67 (0,58) mmol/l y  densidad 1.014,5 (0,2) kg/m3. Para la solución de anidulafungina 5  mg/ml los resultados obtenidos fueron: pH 4,22 (0,01), osmolalidad  464,67 (2,52) mOsm/kg, contenido en cloruros 137,00 (0,00) mmol/l y  densidad 1.016,5 (0,2) kg/m3; y para la solución de 10 mg/ml:  osmolalidad 656,33 (1,15) mOsm/kg, contenido en cloruros 132,00  (0,00) mmol/l y densidad 1.029,8 (0,4) kg/m3. Conclusiones: Los valores de pH, osmolalidad, contenido en cloruros y densidad resultaron adecuados para una correcta tolerabilidad  ediante nebulización.