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.