Antifungal Drug Levels/Therapeutic Drug Monitoring (Fluconazole, Itraconazole, Posaconazole, Voriconazole, Micafungin, Amphotericin)
CPT Code(s)
80299 (previous CPT code 82491)
Synonym(s)
N/A
Performed
In-House
Methodology
- HPLC: voriconazole, micafungin, caspofungin, amphotericin B, posaconazole;
- UPLC/MS: fluconazole, itraconazole, posaconazole, isavuconazole
Panel/Profile Components
N/A
Critical Values
Voriconazole level 6.0 mcg/ml
Specimen Collection / Handling Requirements
Serum or plasma separated from whole blood is required. Samples must remain frozen if the time from separation to delivery to our laboratory exceeds 24 hours. Samples for measurement of amphotericin B or micafungin concentrations must be protected from light, as these agents are light sensitive.
Minimum Specimen Requirements
1. Minimum plasma/serum volume requirements:
2. Voriconazole – 0.5 ml
3. Amphotericin B – 0.5 ml
4. Micafungin – 0.5 ml
5. Caspofungin – 0.5 ml
6. Fluconazole – 0.25 ml
7. Itraconazole – 0.5 ml
8. Posaconazole – 0.5 ml
9. Isavuconazole – 0.5 ml
Turnaround time
a. Total testing time: 6 hours
b. Results to Client: 72 hours
Communication
a. Turnaround time non-conformity: Email or call Pathologist on request form to notify them of the delay.
b. Specimen rejection: Cause for specimen rejection is noted after the sample has arrived at UT Health San Antonio and the Pathologist on the request form or applicable personnel will be contacted by email or phone.
c. Technical Updates: Email Applicable Laboratory Director.
Quality
Three control concentrations along with standard curve are performed for each assay at the time of each run. Suitability of control concentrations (within + 2 SD from mean concentration of each control) assessed by technologist and director before results are released.