Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection
Mortality and morbidity due to invasive fungal infections have increased over the years. Posaconazole is a second-generation triazole agent with an extended spectrum of activity, which shows a high interindividual variability in its plasma levels, rendering dosing in many patients inconsistent or in...
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doaj-eed8142e89144e839016c1d5236b7b242020-11-24T21:45:37ZengMDPI AGBiomedicines2227-90592017-11-01546610.3390/biomedicines5040066biomedicines5040066Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal InfectionSarah Allegra0Giovanna Fatiguso1Silvia De Francia2Fabio Favata3Elisa Pirro4Chiara Carcieri5Amedeo De Nicolò6Jessica Cusato7Giovanni Di Perri8Antonio D’Avolio9Department of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Biological and Clinical Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano (TO), ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Biological and Clinical Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano (TO), ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyDepartment of Medical Sciences, Unit of Infectious Diseases, University of Torino, ASL Città di Torino, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, ItalyMortality and morbidity due to invasive fungal infections have increased over the years. Posaconazole is a second-generation triazole agent with an extended spectrum of activity, which shows a high interindividual variability in its plasma levels, rendering dosing in many patients inconsistent or inadequate. Hence, posaconazole therapeutic drug monitoring, which is easily available in clinical practice, may improve treatment success and safety. The aim of the study was to describe posaconazole pharmacokinetics, and to evaluate the utility of therapeutic drug monitoring for therapy and prophylaxis in a cohort of adult patients. A fully validated chromatographic method was used to quantify posaconazole concentration in plasma collected from adult patients at the end of the dosing interval. Associations between variables were tested using the Pearson test. The Mann-Whitney test was used to probe the influence of categorical variables on continuous ones. A high inter-individual variability was shown. Of the 172 enrolled patients, among those receiving the drug by the oral route (N = 170), gender significantly influenced drug exposure: males showed greater posaconazole concentration than females (p = 0.028). This study highlights the importance of therapeutic drug monitoring in those with invasive fungal infections and its significant clinical implications; moreover we propose, for the first time, the possible influence of gender on posaconazole exposure.https://www.mdpi.com/2227-9059/5/4/66therapeutic drug monitoring (TDM)triazolesHPLCantifungalinvasive fungal infections (IFIs) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sarah Allegra Giovanna Fatiguso Silvia De Francia Fabio Favata Elisa Pirro Chiara Carcieri Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D’Avolio |
spellingShingle |
Sarah Allegra Giovanna Fatiguso Silvia De Francia Fabio Favata Elisa Pirro Chiara Carcieri Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D’Avolio Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection Biomedicines therapeutic drug monitoring (TDM) triazoles HPLC antifungal invasive fungal infections (IFIs) |
author_facet |
Sarah Allegra Giovanna Fatiguso Silvia De Francia Fabio Favata Elisa Pirro Chiara Carcieri Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D’Avolio |
author_sort |
Sarah Allegra |
title |
Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection |
title_short |
Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection |
title_full |
Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection |
title_fullStr |
Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection |
title_full_unstemmed |
Evaluation of Posaconazole Pharmacokinetics in Adult Patients with Invasive Fungal Infection |
title_sort |
evaluation of posaconazole pharmacokinetics in adult patients with invasive fungal infection |
publisher |
MDPI AG |
series |
Biomedicines |
issn |
2227-9059 |
publishDate |
2017-11-01 |
description |
Mortality and morbidity due to invasive fungal infections have increased over the years. Posaconazole is a second-generation triazole agent with an extended spectrum of activity, which shows a high interindividual variability in its plasma levels, rendering dosing in many patients inconsistent or inadequate. Hence, posaconazole therapeutic drug monitoring, which is easily available in clinical practice, may improve treatment success and safety. The aim of the study was to describe posaconazole pharmacokinetics, and to evaluate the utility of therapeutic drug monitoring for therapy and prophylaxis in a cohort of adult patients. A fully validated chromatographic method was used to quantify posaconazole concentration in plasma collected from adult patients at the end of the dosing interval. Associations between variables were tested using the Pearson test. The Mann-Whitney test was used to probe the influence of categorical variables on continuous ones. A high inter-individual variability was shown. Of the 172 enrolled patients, among those receiving the drug by the oral route (N = 170), gender significantly influenced drug exposure: males showed greater posaconazole concentration than females (p = 0.028). This study highlights the importance of therapeutic drug monitoring in those with invasive fungal infections and its significant clinical implications; moreover we propose, for the first time, the possible influence of gender on posaconazole exposure. |
topic |
therapeutic drug monitoring (TDM) triazoles HPLC antifungal invasive fungal infections (IFIs) |
url |
https://www.mdpi.com/2227-9059/5/4/66 |
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