Posaconazole plasma concentrations in children and adolescent

Abstract

Although posaconazole is licensed only for use in children over 13 years of age, it has been also used in younger children for invasive fungal infections prophylaxis. Its variable and unpredictable oral bioavailability and its saturable absorption, make it difficult to determine the optimal dosing regimen. Hence, therapeutic drug monitoring could improve drug treatment success and safety. Here we described posaconazole pharmacokinetics in paediatrics and we evaluated the role of therapeutic drug monitoring for therapy and prophylaxis. A chromatographic method was used to determine posaconazole exposure in plasma. Pearson and Mann-Whitney U test were used. A high inter-individual variability was shown; an inverse and significant correlation was found among drug concentration and its dose. Moreover, in adolescent, we observed an inverse correlation between drug exposure and age and the influence of sex of PSC levels. These results highlights that strict therapeutic drug monitoring is required to achieved an adequate target posaconazole serum levels.