Antifungal Drug Levels

VORICONAZOLE– (VORI, HPLC) CPT 80285

Voriconazole levels are assayed by HPLC. The lowest limit of quantitation (LOQ) for voriconazole is 0.2 µg/ml. Plasma/serum, CSF, and other body fluids may be assayed for voriconazole levels. However, this assay has only been validated for measurement of voriconazole in plasma.

POSACONAZOLE (POS, HPLC) CPT 80187

Posaconazole levels are assayed by HPLC. The lowest limit of quantitation (LOQ) for posaconazole is 0.125 µg/ml. The assay has been validated for plasma/serum levels; however, the drug may be measured in CSF and other biological fluids.

ITRACONAZOLE (ITRA, UPLC/MS) CPT 80189

Itraconazole levels are assayed by UPLC/MS technology with both the parent compound and its largest metabolite (hydroxy-itraconazole) being reported. The lowest limit of quantitation (LOQ) validated for itraconazole by UPLC/MS for this laboratory is 0.25 µg/ml. The assay has been validated for plasma/serum levels; however, the drug may be measured in CSF and other biological fluids. 

FLUCONAZOLE (UPLC/MS) CPT 80299

Fluconazole levels are assayed by UPLC/MS. The lowest limit of quantitation (LOQ) validated for fluconazole by UPLC/MS for this laboratory is 0.25 micrograms/ml (µg/ml). Assays can be done on CSF, bile, peritoneal fluid, dialysate, and other biological fluids.

ISAVUCONAZOLE (ISA, UPLC/MS) CPT 80299

Isavuconazole levels are assayed by UPLC/MS. The lowest limit of quantitation is 0.25 µg/ml. The assay has been validated for plasma/serum levels.

AMPHOTERICIN – B (AMB, HPLC) CPT 80299

Amphotericin B levels are assayed by HPLC. The lowest limit of quantitation (LOQ) validated for amphotericin B by HPLC for this laboratory is 0.05 µg/ml. Levels can be measured following the administration of amphotericin B deoxycholate or a lipid formulation of amphotericin B (e.g., liposomal amphotericin B, amphotericin B lipid complex). This assay has been validated for plasma/serum, however other bodily fluids may be assayed for amphotericin B levels. Samples should be protected from light.

To Send Samples

REQUISITION – Fungus Testing Laboratory requisitions are required. If your laboratory does not have one, it can be downloaded or printed from our website. Alternatively, please call and one will be faxed to you. Please indicate all pertinent information such as patient’s name, requesting entity, address, contact, phone/fax numbers, etc. Also indicate on the requisition the dosage, patient’s date/time of last dose and date/time of sample drawn.

Testing Schedule

UPLC/HPLC: – Set up Monday – Friday depending on the test and workload. Reports 24 hours following the date of setup except for samples set up on Friday.

Specimen Requirements

Sample Type- Plasma or other biological fluids including CSF, bile, peritoneal fluid, dialysate, or other biological fluids or tissues may be assayed for antifungal agents. Draw plasma samples using EDTA (lavender tubes). Do not use gel separator tubes as these may result in assay interference.

Plasma or other biological fluids including CSF, bile, peritoneal fluid, dialysate, or other biological fluids or tissues may be assayed for antifungal agents. Draw plasma samples using EDTA (lavender tubes).

SPECIAL HANDLING– Samples should be frozen until shipment and sent to the Fungus Testing Laboratory overnight frozen (preferably on dry ice). Amphotericin B and micafungin samples should be protected from light.

SAMPLE AMOUNT – 0.5 to 1.0 ml of serum/plasma or other fluid.

SHIPMENT – Please ship samples to arrive Tuesday through Friday, as the University is closed on Saturday and Sunday. Pack samples in proper container and ship for overnight delivery on dry ice. Shipping fees are the responsibility of the sender. Note: Voriconazole samples may be shipped on cold packs.

RESULTS – Results are typically available 48 – 72 hours from receipt of sample, depending on when the sample is received. Samples received on Friday may not be completed until Tuesday of the following week. All reports are mailed after completion. We will also phone or FAX the report if so instructed on the requisition.

Fungus Testing Laboratory Services

Direct Line: 210-567-4029