The study was reviewed and approved by the hospital's ethics committee, and patients signed an informed consent form. Inclusion criteria: patients receiving prophylactic or therapeutic voriconazole in the haematology, ICU and emergency departments. Exclusion criteria: Patients under 18 years of age; patients using drugs that have a serious effect on voriconazole pharmacokinetics (e.g. P450 enzyme inducers and inhibitors, such as rifampicin, ritonavir, phenytoin, carbamazepine, phenobarbital, Hypericum perforatum and cimetidine); patients combination using other antifungal drugs; patients who have discontinued voriconazole due to ineffective treatment or serious adverse effects; patients with hepatic or renal abnormalities in the early stage of treatment.

The comprehensive indicators of effective treatment included the following: Patients did not develop breakthrough fungal infections. Patients were still alive seven days after the end of treatment. Patients' fever subsided, or their maximum body temperature was below 38°C after the end of treatment. There was no premature discontinuation of drugs due to ineffective treatment or adverse reactions. The specific efficacy evaluation indexes were as follows: 'cured', meaning that symptoms, signs, laboratory tests and pathogenicity tests returned to normal; 'apparent effect', meaning that the condition was significantly improved and the results of fungal infections became negative, but one of the signs or laboratory tests was not completely normal; 'progress', meaning that the condition improved, but not obviously; and 'ineffective', meaning that there was no obvious progress or the condition aggravated after 72 hours of drug use.

1.General information: This study included 17 patients, comprising 6 from the surgical ICU, 1 from the emergency ICU, and 10 from the hematology department. There were 12 males and 5 females, with an average age of 68.5 ± 17.4 years.

2.Drug administration and determination of blood concentration: Patients 1 and 2 were given 300 mg; patient 5 was given 400 mg; and the others were given 200 mg. Patient 17 was given QD, and the others were given Q12H. The collection of venous blood from the 17 patients, the administration of the drug and the determination of the results of the concentration and the patients' conditions are shown in Table 1.

3.Evaluation of therapeutic efficacy: Of the 17 patients treated with voriconazole, 12 showed an obvious effect, two made progress and three were ineffective. One patient left the hospital after giving up treatment due to a combination of diseases unrelated to infection, including multiple myeloma, cardiac failure and acute renal failure. The patient's condition was complex and critical due to low immunity caused by chemotherapy, which ultimately failed to clear the infection.

4.Safety evaluation: Five patients treated with voriconazole had abnormal liver function, and one of them had abnormal liver function indexes prior to treatment. As the patients were taking multiple medications, it was not possible to determine whether the liver function abnormality was caused by voriconazole. The patients improved following hepatoprotective and enzyme-lowering treatment. Two patients experienced visual impairment; one recovered after reducing the daily dosage of voriconazole and the other recovered during the course of treatment. One patient experienced hallucinations which also resolved during the course of treatment. None of the patients experienced fever, headache, abdominal pain, diarrhea, or respiratory disorders. None of the patients experienced adverse reactions such as fever, headache, abdominal pain, diarrhea or respiratory disturbances.