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Antimicrobial Agents and Chemotherapy, November 2008, p. 4172-4174, Vol. 52, No. 11
0066-4804/08/$08.00+0     doi:10.1128/AAC.00805-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Inhibition of Voriconazole Metabolism by Chloramphenicol in an Adolescent with Central Nervous System Aspergillosis{triangledown}

Verena Hafner,1,§ Nadine Albermann,2,§ Walter E. Haefeli,1* and Friedrich Ebinger3

Department of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany,1 Department of Pediatrics, Neonatology, Im Neuenheimer Feld 153, D-69120 Heidelberg, Germany,2 Department of Pediatrics, Pediatric Neurology, Im Neuenheimer Feld 153, D-69120 Heidelberg, Germany3

Received 19 June 2008/ Returned for modification 31 July 2008/ Accepted 7 September 2008

For an adolescent with bacterial meningitis and subsequent cerebral aspergillosis, intravenous voriconazole dose requirements substantially decreased during coadministration with intravenous chloramphenicol and considerably rose after discontinuation of the antibiotic. In agreement with in vitro evidence, these data suggest that chloramphenicol is a rather significant inhibitor of hepatic CYP3A4 and/or CYP2C19.

* Corresponding author. Mailing address: Department of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Phone: 49 6221 56 8740. Fax: 49 6221 56 4642. E-mail: walter.emil.haefeli{at}med.uni-heidelberg.de

{triangledown} Published ahead of print on 15 September 2008.

§ Both authors contributed equally to this work.

Antimicrobial Agents and Chemotherapy, November 2008, p. 4172-4174, Vol. 52, No. 11
0066-4804/08/$08.00+0     doi:10.1128/AAC.00805-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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