Conclusions

This study suggests that the TBIL, PLT and WT are significantly associated with voriconazole pharmacokinetic parameters. TBIL is a critical factor leading to large pharmacokinetic variation of voriconazole. Using MCS to optimize the dosing regimen in patients with liver dysfunction based on our PPK model and TBIL stratification we demonstrated that lower doses and longer administration intervals should be considered for patients with liver dysfunction. This is helpful for clinicians making decisions about voriconazole dosing regimens, especially to determine efficient initial dosing strategies and in primary hospitals where TDM is not available.