Antifungal prophylaxis with posaconazole tablet and oral suspension in patients with haematologic malignancy: Therapeutic drug monitoring, efficacy and risk factors for the suboptimal level

Summary Background Posaconazole is used to prevent invasive fungal infections (IFIs) in patients with haematologic malignancy. In this study, we compared plasma posaconazole concentrations (PPCs) and the incidence of breakthrough IFIs between patients with haematologic malignancy receiving posaconaz...

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Bibliographic Details
Published in:Mycoses 2020-01, Vol.63 (1), p.89-94
Main Authors: Oh, Jihyu, Kang, Cheol‐In, Kim, Si‐Ho, Huh, Kyungmin, Cho, Sun Young, Chung, Doo Ryeon, Lee, Soo‐Youn, Jung, Chul Won, Peck, Kyong Ran
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Antifungal Agents - therapeutic use
antifungal prophylaxis
Chemotherapy
Drug Monitoring
Female
haematologic malignancy
Hematologic Neoplasms - complications
Hematologic Neoplasms - microbiology
Humans
Hypoalbuminemia - blood
Invasive Fungal Infections - drug therapy
Invasive Fungal Infections - prevention & control
Labeling
Male
Malignancy
Middle Aged
Number systems
Posaconazole
Prophylaxis
Retrospective Studies
Risk Factors
Suspensions - pharmacology
Tablets
Tablets - pharmacology
therapeutic drug monitoring
Treatment Outcome
Triazoles - administration & dosage
Triazoles - adverse effects
Triazoles - blood
Triazoles - therapeutic use
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Summary:Summary Background Posaconazole is used to prevent invasive fungal infections (IFIs) in patients with haematologic malignancy. In this study, we compared plasma posaconazole concentrations (PPCs) and the incidence of breakthrough IFIs between patients with haematologic malignancy receiving posaconazole oral suspension vs tablet. Methods We retrospectively collected data on adult patients with haematologic malignancies who received posaconazole prophylaxis during chemotherapy from April 2014 through May 2018. A total of 242 cases with PPCs, 88 in the oral suspension group and 154 in the tablet group, were included in this study. Results Patients receiving tablets achieved a significantly higher mean PPC than did those on oral suspension (1.631 ± 0.878 μg/mL in the tablet group vs. 0.879 ± 0.585 μg/mL in the oral suspension group). One hundred and thirty‐seven of 154 patients (89.0%) receiving tablets had PPCs of 0.7 μg/mL or more, while only 41 of 88 patients (46.6%) receiving oral suspension attained an optimal level (P 
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.13020