Posaconazole in lung transplant recipients: use, tolerability, and efficacy
Background Fungal infection is a common cause of mortality and morbidity in lung transplant recipients (LuTR). Treatment failure to first‐line antifungals because of resistance or intolerance is an increasing problem. Posaconazole (PCZ), a triazole antifungal, is an attractive treatment option. Meth...
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Published in | Transplant infectious disease Vol. 18; no. 2; pp. 302 - 308 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Denmark
Blackwell Publishing Ltd
01.04.2016
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Fungal infection is a common cause of mortality and morbidity in lung transplant recipients (LuTR). Treatment failure to first‐line antifungals because of resistance or intolerance is an increasing problem. Posaconazole (PCZ), a triazole antifungal, is an attractive treatment option.
Methods
We performed a single‐center retrospective study to describe the use, tolerability, efficacy, and drug interaction effect (with tacrolimus) of PCZ oral suspension in LuTR.
Results
Seventy‐eight patients were treated with PCZ oral suspension for prophylaxis (n = 15), pre‐emptive treatment (n = 31), and treatment of possible (n = 7) and probable (n = 25) invasive fungal infection. A range of fungal isolates was encountered. Resolution was observed in 52.4% (probable, possible, and pre‐emptive treatment groups). Aggregate all‐cause 1‐year mortality was 12.8%. PCZ was well tolerated with 11.5% of patients experiencing adverse effects. Despite dose adjustment strategies, 11.7% of patients experienced supratherapeutic tacrolimus levels, which in 5 cases was associated with a rise (mean 21.6 μmol/L) in serum creatinine.
Conclusions
PCZ is well tolerated and appears effective in the management of fungal infection after lung transplantation. Patients receiving concurrent tacrolimus require careful therapeutic drug monitoring. |
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Bibliography: | Merck Sharp & Dohme ArticleID:TID12497 istex:4F44242B2F4CF3DD6ECFC841E0DA1CE63631A7ED ark:/67375/WNG-5WFCZ56M-7 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1398-2273 1399-3062 |
DOI: | 10.1111/tid.12497 |