Salvage treatment of histoplasmosis with posaconazole

• Published in: The Journal of infection Vol. 54; no. 4; pp. 319 - 327
• Main Authors: Restrepo, Angela, Tobón, Angela, Clark, Benjamin, Graham, Donald R, Corcoran, Gavin, Bradsher, Robert W, Goldman, Mitchell, Pankey, George, Moore, Thomas, Negroni, Ricardo, Graybill, John R
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.04.2007; Elsevier
• Subjects: Adolescent; Adult; Aged, 80 and over; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antifungal Agents - administration & dosage; Antifungal Agents - adverse effects; Antifungal Agents - therapeutic use; Biological and medical sciences; Cerebrospinal Fluid - microbiology; Disseminated; Ethmoid Sinusitis - drug therapy; Ethmoid Sinusitis - microbiology; Female; Histoplasma - drug effects; Histoplasma - isolation & purification; Histoplasmoses; Histoplasmosis - drug therapy; Histoplasmosis - microbiology; Human mycoses; Humans; Infectious Disease; Infectious diseases; Invasive fungal infection; Lung Diseases, Fungal - drug therapy; Lung Diseases, Fungal - microbiology; Male; Maxillary Sinusitis - drug therapy; Maxillary Sinusitis - microbiology; Medical sciences; Meningitis, Fungal - drug therapy; Meningitis, Fungal - microbiology; Middle Aged; Mycoses; Pharmacology. Drug treatments; Posaconazole; Salvage Therapy; Salvage treatment; Treatment Outcome; Triazoles - administration & dosage; Triazoles - adverse effects; Triazoles - therapeutic use; Tropical mycoses; Invasive fungal infection; Salvage treatment; Disseminated; Posaconazole; Infection; Antifungal agent; Histoplasmosis; Mycosis; Triazole derivatives
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2006.05.006

Summary Six patients received salvage treatment with posaconazole oral suspension (800 mg/day in divided doses) for severe forms of histoplasmosis. One patient had pulmonary disease and 5 had disseminated disease. Previous antifungal therapy consisted of amphotericin B, itraconazole, fluconazole, or voriconazole. Posaconazole treatment duration for individual patients ranged from 6 weeks to 34 weeks. All patients had successful clinical outcomes with significant clinical improvements noted during the first month of therapy. Although the number of patients evaluated in this case series is small, the findings are encouraging and provide preliminary evidence that posaconazole may be a useful salvage treatment option for histoplasmosis involving a variety of infected tissues and organs.