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Published on: March 1, 2024
Clinical experience with posaconazole in patients with invasive mucormycosis: a case series
Michelle M González-Ramos1, Jorge Bertrán-Pasarell, Humberto Guiot
1Department of Internal Medicine, Infectious Diseases Section, University of Puerto Rico School of Medicine, PO Box 365067, San Juan, PR. mgonzalezmd@yahoo.com
Abstract:
Posaconazole (POS) is approved for prophylaxis of Aspergillus and Candida infections in immunocompromised patients and for the treatment of oropharyngeal candidiasis. Data is limited as step-down therapy after treatment with amphotericin B (AMB). Four cases with refractory mucormycosis who had a favorable response after a change in antifungal therapy to POS are presented. In these four patients, POS demonstrated to be an effective therapeutic option in the management of refractory mucormycosis. Further studies should be conducted to define its role, whether as a single agent or as adjuvant therapy in combination with AMB.
Insights
Posaconazole (POS) shows promise as a step-down therapy for refractory mucormycosis, offering a favorable response in immunocompromised patients. Further research is needed to establish its role in combination with amphotericin B (AMB).
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Posaconazole (POS) is approved for prophylaxis and treating certain fungal infections.
- Limited data exists on POS as step-down therapy after amphotericin B (AMB) treatment.
- Mucormycosis is a serious fungal infection, particularly in immunocompromised individuals.
Observation:
- Four cases of refractory mucormycosis are presented.
- Patients experienced a favorable response after switching antifungal therapy to POS.
- POS was administered as a step-down treatment following initial AMB therapy.
Findings:
- Posaconazole demonstrated efficacy in managing refractory mucormycosis in these cases.
- A favorable treatment response was observed in all four patients.
- POS served as an effective therapeutic option for difficult-to-treat mucormycosis.
Implications:
- Posaconazole may be a viable therapeutic option for refractory mucormycosis.
- Further studies are warranted to define POS's role as a single agent or in combination with AMB.
- This case series suggests potential for POS in salvage therapy for mucormycosis.
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