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Successful enteral administration of crushed posaconazole delayed-release tablets in children

Laura L Bio1, Lyndsie Hiroshima1, Hayden T Schwenk2

  • 1Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA.

Pediatric Blood & Cancer
|November 22, 2023
PubMed

Insights

Crushed posaconazole delayed-release tablets (POS-DRT) offer a promising enteral option for pediatric patients. This study found that crushed POS-DRT achieved target concentrations in 90% of pediatric encounters, supporting its use for antifungal therapy.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Infectious Diseases

Background:

  • Posaconazole oral suspension exhibits erratic absorption, requiring frequent dosing and food intake.
  • Enteral formulations are needed for pediatric patients unable to tolerate standard oral intake.
  • Crushed posaconazole delayed-release tablets (POS-DRT) show potential, but pediatric data is limited.

Purpose of the Study:

  • To evaluate the efficacy of crushed POS-DRT as an enteral formulation in pediatric patients.
  • To determine if crushed POS-DRT can achieve target posaconazole concentrations in children.

Main Methods:

  • Retrospective analysis of 10 encounters involving nine pediatric patients.
  • Administration of crushed POS-DRT via enteral routes.
  • Therapeutic drug monitoring of posaconazole concentrations.

Main Results:

  • Target posaconazole concentrations were achieved in 90% of pediatric patient encounters.
  • Crushed POS-DRT demonstrated successful delivery of posaconazole in a pediatric population.
  • No significant adverse events related to crushed POS-DRT administration were noted.

Conclusions:

  • Crushed POS-DRT represents a viable enteral alternative for pediatric posaconazole administration.
  • This formulation may improve adherence and therapeutic outcomes in pediatric antifungal prophylaxis and treatment.
  • Further research should confirm these findings in larger pediatric cohorts.

Keywords:
antifungalazolefungal infectionstherapeutic drug monitoring

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