open access

Vol 52, No 6 (2021)
Original research article
Submitted: 2021-07-25
Accepted: 2021-10-13
Published online: 2021-11-08
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Therapeutic drug monitoring of posaconazole for effective prophylaxis of invasive fungal infections in pediatric patients: a pilot study

Karolina Liszka1, Matylda Resztak2, Paulina Zalewska2, Krzysztof Kałwak1
DOI: 10.5603/AHP.2021.0101
·
Acta Haematol Pol 2021;52(6):578-583.
Affiliations
  1. Department of Paediatric Bone Marrow Transplantation, Oncology, and Haematology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
  2. MonitLab Sp. z o.o., Poznan, Poland

open access

Vol 52, No 6 (2021)
ORIGINAL RESEARCH ARTICLE
Submitted: 2021-07-25
Accepted: 2021-10-13
Published online: 2021-11-08

Abstract

Introduction: Posaconazole, a second-generation triazole agent, is a drug with wide interindividual variation in bioavailability and variability of pharmacokinetics. The European Conference on Infections in Leukemia recommends the implementation of posaconazole therapeutic drug monitoring (TDM) in children to provide certainty regarding the efficacy of treatment and to increase its safety. A concentration of posaconazole in plasma in prophylactic regimens of above 0.7 mg/L is recommended.

The aim of our pilot study was to discover the most effective method of posaconazole plasma concentration measurement, and to analyze posaconazole pharmacokinetics profiles in pediatric patients on posaconazole prophylaxis.

Material and methods: Children receiving oncological treatment or hematopoietic stem cell transplantation in the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology in Wroclaw Medical University Hospital were included in the trial. Posaconazole concentration was determined at the MonitLabTM laboratory using a newly validated high-performance liquid chromatography with fluorescence detector method.

Results: Initial analysis shows that the major problem in patients on antifungal prophylaxis is inadequately low plasma drug concentration.

Conclusions: Clinical trials on TDM of posaconazole should be developed.

Abstract

Introduction: Posaconazole, a second-generation triazole agent, is a drug with wide interindividual variation in bioavailability and variability of pharmacokinetics. The European Conference on Infections in Leukemia recommends the implementation of posaconazole therapeutic drug monitoring (TDM) in children to provide certainty regarding the efficacy of treatment and to increase its safety. A concentration of posaconazole in plasma in prophylactic regimens of above 0.7 mg/L is recommended.

The aim of our pilot study was to discover the most effective method of posaconazole plasma concentration measurement, and to analyze posaconazole pharmacokinetics profiles in pediatric patients on posaconazole prophylaxis.

Material and methods: Children receiving oncological treatment or hematopoietic stem cell transplantation in the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology in Wroclaw Medical University Hospital were included in the trial. Posaconazole concentration was determined at the MonitLabTM laboratory using a newly validated high-performance liquid chromatography with fluorescence detector method.

Results: Initial analysis shows that the major problem in patients on antifungal prophylaxis is inadequately low plasma drug concentration.

Conclusions: Clinical trials on TDM of posaconazole should be developed.

Get Citation

Keywords

posaconazole, therapeutic drug monitoring (TDM), antifungal prophylaxis

About this article
Title

Therapeutic drug monitoring of posaconazole for effective prophylaxis of invasive fungal infections in pediatric patients: a pilot study

Journal

Acta Haematologica Polonica

Issue

Vol 52, No 6 (2021)

Article type

Original research article

Pages

578-583

Published online

2021-11-08

Page views

3110

Article views/downloads

383

DOI

10.5603/AHP.2021.0101

Bibliographic record

Acta Haematol Pol 2021;52(6):578-583.

Keywords

posaconazole
therapeutic drug monitoring (TDM)
antifungal prophylaxis

Authors

Karolina Liszka
Matylda Resztak
Paulina Zalewska
Krzysztof Kałwak

References (19)
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