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[Prophylaxis use of posaconazole (P) in an hemato-oncology unit: a retrospective study]

N Selvy1, M Villiet, S Hansel-Esteller

  • 1Service de pharmacie, CHRU de Montpellier, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.

Pathologie-Biologie
|October 30, 2009
PubMed
Abstract

Insights

Posaconazole (P) prophylaxis is used for leukemia patients with neutropenia. This study found P prophylaxis had a 50% failure rate, suggesting a need for optimized treatment strategies to improve outcomes for high-risk patients.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pharmacology

Context:

  • Acute Myelogenous Leukemia (AML) and other hematologic malignancies carry a high risk of invasive fungal infections (IFI).
  • Severe and prolonged neutropenia following chemotherapy or autologous transplant necessitates antifungal prophylaxis.
  • Posaconazole (P) is a key agent for IFI prophylaxis in these immunocompromised patients.

Purpose:

  • To evaluate the efficacy of posaconazole (P) prophylaxis in preventing invasive fungal infections (IFI) in patients with hematologic malignancies.
  • To identify factors contributing to treatment failure in posaconazole prophylaxis.
  • To assess the incidence of proven/probable IFI in patients receiving posaconazole.

Summary:

  • A retrospective study analyzed 22 patients, primarily with AML, receiving posaconazole for IFI prophylaxis.
  • Posaconazole prophylaxis demonstrated a 50% failure rate, with reasons including suspected IFI, swallowing difficulties, and co-administration with esomeprazole.
  • Only one case of proven/probable IFI occurred, but treatment failures highlight challenges in achieving optimal outcomes.

Impact:

  • Posaconazole prophylaxis appears beneficial but requires optimization in high-risk patients.
  • Late initiation and administration/absorption issues may compromise posaconazole efficacy.
  • Further research into optimizing posaconazole treatment, including therapeutic drug monitoring, is warranted to improve patient safety and treatment success.

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