Utilization of posaconazole oral suspension or delayed‐released tablet salvage treatment for invasive fungal infection

Abstract

Posaconazole may be useful for salvage treatment (ST) for invasive fungal infections (IFIs). The aim of this study was to evaluate the efficacy of posaconazole ST with either posaconazole oral suspension (SUS) or delayed-released tablet (TAB) in patients with IFI. A retrospective review of patients who received posaconazole ST for IFI at the University of Utah Health Sciences Center between December 2007 and March 2014 was conducted. A total of 14 episodes of posaconazole ST for proven (9 episodes) and probable (5 episodes) IFI were identified in 14 patients. The median age was 54 years and the majority of patients (64.3%) had underlying haematological diseases. Posaconazole SUS and TAB were used in 11 episodes and 3 episodes respectively. The duration of posaconazole ST ranged from 28 to 370 days with a median of 65 days. Posaconazole ST with TAB achieved favourable serum posaconazole trough concentrations (median 1.4 μg mL ) compared to posaconazole SUS (median 1.0 μg mL ). The overall clinical success rate with posaconazole ST was 71.4% (10 of 14 episodes). One patient died of progression of IFI. Adverse events were noted in two patients. Posaconazole SUS or TAB may be used effectively for IFI ST.

Posaconazole liquid vs tablet formulation in lung transplant recipients

“…This result is consistent with the findings reported by Moton et al . Furthermore, Kim et al . reported similar results including adverse events for POS‐Liq and POS‐Tab.…”

Intravenous and tablet formulation of posaconazole in antifungal therapy and prophylaxis: A retrospective, non-interventional, multicenter analysis of hematological patients treated in tertiary-care hospitals

“…Furthermore, our study demonstrates only a small number of adverse drug reactions rated as at least possibly associated with novel posaconazole formulations, which is comparable to other published data (Belling et al, 2017;Jeong et al, 2016;Kim et al, 2016). However, a study by Pham et al reported a relatively high rate of hepatotoxity of >10% of the observed patient population who received posaconazole tablet for prophylaxis and therapy of IFDs (Pham et al, 2016).…”

“…Additionally, nine cases (31%) of rare proven mucormycosis, fusariosis, and trichosporosis were included in the therapy group, well known for high morbidity, mortality, and treatment costs (Heimann et al, 2019;Menzin et al, 2009;Seidel et al, 2017). Nevertheless, the failure rate as reported by the participating investigators is higher than those in previously reported studies (Jeong et al, 2016;Kim et al, 2016;Yi et al, 2017). The high mortality rate in this patient population underlines the urgent need of appropriate empiric and targeted antifungal therapy with respect to both, clinical outcome and associated costs (Zilberberg et al, 2010).…”

Disseminated Pulmonary with Isolated Muscular Mucormycosis in an Acute Myeloid Leukemia Patient: A Case Report and Literature Review

“…Posaconazole is a promising alternative and currently used as a salvage therapy for refractory mucormycosis or as step-down therapy [12,33]. Multiple retrospective studies evaluated the utilization of posaconazole as salvage therapy in patients with refractory mucormycosis or intolerance to amphotericin B and showed a favorable response in around 60% of patients [34–36]. A new azole, isavuconazole, is the only approved oral antifungal for the treatment of mucormycosis [33,37].…”