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Posaconazole salvage therapy: The Posifi study
Author(s) -
Fortun Jesús,
Gioia Francesca,
Cardozo Celia,
Gudiol Carlota,
Diago Elena,
José Castón Juan,
Muñoz Patricia,
López Javier,
PuertaAlcalde Pedro,
Enzenhofer Matías,
Ramos Antonio,
Frutos Azahara,
Machado Marina,
GarciaVidal Carolina,
Parody Rocío,
MartínDávila Pilar
Publication year - 2019
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12911
Subject(s) - posaconazole , medicine , zygomycosis , salvage therapy , aspergillosis , refractory (planetary science) , antifungal , surgery , mycosis , gastroenterology , amphotericin b , chemotherapy , dermatology , immunology , biology , astrobiology
Summary Background Posaconazole (PCZ) is used mainly for the prevention of invasive fungal infection (IFI). Methods A multicentre retrospective, investigational study using a non‐randomized, single‐arm design carried out in six tertiary hospitals in Spain to evaluate the use of PCZ in different forms of administration in the (non‐prophylactic) treatment of IFI. Results Over an eight‐year‐period, 67 patients were included in this study. PCZ was administered as salvage therapy (intolerant or refractory to a previous antifungal agent) in 65/67 (97%); of these, it was used against Aspergillosis (68.6%), Zygomycosis (13.4%), other moulds (8.9%) and yeast (10.5%). The median duration of PCZ therapy was 75 days. The oral solution was associated with low serum levels (<0.7 mg/L) in 63% of available patients. Clinical response at 3 and 12 months of PCZ therapy were for aspergillosis: 47.8% and 41.3%; for zygomycosis: 55.5% and 55.5%; and for other mycoses: 69.2% and 69.2%, respectively. Suspension by toxicity was only observed in 6% and 7.5% of patients at 3 and 12 months, respectively, mainly with grade III/IV elevations of liver function test (LFTs). Conclusions Posaconazole salvage therapy, especially oral tablets, can be an effective alternative option for patients with IFI who cannot tolerate or do not respond to other antifungal therapies.