Therapeutic Drug Monitoring of Posaconazole: an Update

• Published in: Current fungal infection reports Vol. 10; no. 2; pp. 51 - 61
• Main Authors: Dekkers, Bart G. J., Bakker, Martijn, van der Elst, Kim C. M., Sturkenboom, Marieke G. G., Veringa, Anette, Span, Lambert F. R., Alffenaar, Jan-Willem C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 2016
• Subjects: Clinical Mycology Lab Issues (K Lagrou; Clinical Mycology Lab Issues (K Lagrou, Section Editor); Infectious Diseases; Internal Medicine; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Pneumology/Respiratory System; Section Editor; Topical Collection on Clinical Mycology Lab Issues; Tropical Medicine; Therapeutic drug monitoring; Mucormycosis; Pharmacodynamics; Dried blood spot; Prophylaxis; infections; Invasive fungal infection; Invasive aspergillosis; Posaconazole; Pharmacokinetics; Fusarium infections; Scedosporium infections
• ISSN: 1936-3761; 1936-377X
• DOI: 10.1007/s12281-016-0255-4

Posaconazole is a second-generation triazole agent with a potent and broad antifungal activity. In addition to the oral suspension, a delayed-release tablet and intravenous formulation with improved pharmacokinetic properties have been introduced recently. Due to the large interindividual and intraindividual variation in bioavailability and drug-drug interactions, therapeutic drug monitoring (TDM) is advised to ensure adequate exposure and improve clinical response for posaconazole. Here, we highlight and discuss the most recent findings on pharmacokinetics and pharmacodynamics of posaconazole in the setting of prophylaxis and treatment of fungal infections and refer to the challenges associated with TDM of posaconazole.