5. CONCLUSION
In our article, we observed strong signals of higher frequency of
reporting hepatic dysfunction events associated with voriconazole in the
events of hepatic function abnormal. The median time to event of the
hepatic dysfunction events were 8 days. Most hepatic related adverse
events appeared within the first 15 days since the initiation of
voriconazole administration. Moreover, an increased hepatic dysfunction
event reporting was found in voriconazole when compared with
fluconazole, isavuconazole and amphotericin B. Whereas, in our study, we
observed that echinocandins exhibited a higher hepatotoxicity, which is
inconsistent with the results of previous clinical studies and need
further studies. In any case, since the risk of developing liver injury
and possible hepatic dysfunction by an antifungal agent depends on
several factors including underlying hepatic disease, close clinical and
laboratory monitoring, including TDM for specific antifungal drugs, is
essential in the majority of these patients in order to prevent or
promptly recognize further deterioration of the hepatic function, thus
avoiding unfavorable outcomes.