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ESR 1.3: Optimized administration of antimicrobial drugs for prophylaxis in immunocompromised patients



Prophylaxis is often prescribed to prevent infections in immuno-compromised patients. However, antimicrobial drugs used for prophylaxis are often prescribed in a one size fits all strategy, which may lead to break through infections or adverse drug effects. The PhD student will be supervised by the experts who successfully raised awareness of this problem. Training will address adequate dosing of the most important antimicrobial drugs used for prophylaxis in immuno-compromised patients: valganciclovir, co-trimoxazole and ciprofloxacin, fluconazole, posaconazole and voriconazole. You will evaluate current practice and develop a dosing algorithm for optimized administration of antimicrobial drugs for prophylaxis. Pharmacokinetic modeling to support the dose algorithm will be followed at the University of Liverpool under supervision of prof William Hope. In addition, cost effectiveness of different dosing strategies will be calculated. An internship at MSD on pharmaco-vigilance and medical information for healthcare professionals will be an integral part of the PhD training.


  • Dr. JWC Alffenaar, hospital pharmacist – clinical pharmacologist
  • Prof. dr. TS van der Werf, chest physician – infectious diseases expert


University of Liverpool, UK
MSD, The Netherlands

Relevant publications

  1. van der Elst KCM, Pereboom M, van den Heuvel ER, Kosterink JGW, Scholvinck EH, Alffenaar J-WC. Insufficient fluconazole exposure in pediatric cancer patients and the need for therapeutic drug monitoring in critically ill children. Clin Infect Dis. 2014 Dec 1;59(11):1527–33.
  2. Ventura MAE, van Wanrooy MJP, Span LFR, Rodgers MGG, van den Heuvel ER, Uges DRA, et al. Longitudinal analysis of the effect of inflammation on voriconazole trough concentrations. Antimicrob Agents Chemother. 2016 Feb 16.
  3. Huurneman LJ, Neely M, Veringa A, Docobo Perez F, Ramos-Martin V, Tissing WJ, et al. Pharmacodynamics of Voriconazole in Children. Antimicrob Agents Chemother. 2016 Apr;60(4):2336–42.


Immuno-compromised patients, prophylaxis, individualized dosing