Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions.
BACKGROUND
Conventional amphotericin B-based antifungal therapy for invasive fusariosis in patients with a hematologic malignancy results in a > or = 70% failure rate. Posaconazole is a broad-spectrum antifungal agent with in vitro and in vivo activity against Fusarium species.


METHODS
In this retrospective analysis of patients from 3 open-label clinical trials, we evaluated posaconazole for the treatment of invasive fusariosis. Twenty-one patients with proven or probable invasive fusariosis who had disease refractory to or who were intolerant of standard antifungal therapy received oral posaconazole suspension (800 mg per day in divided doses) as salvage therapy.


RESULTS
Successful outcome occurred in 10 (48%) of all 21 patients. Among patients with leukemia who received posaconazole therapy for >3 days, the overall success rate was 50%; for patients who recovered from myelosuppression, the success rate was 67%, compared with 20% for those with persistent neutropenia.


CONCLUSIONS
These results suggest that posaconazole is useful for the treatment of invasive fusariosis.
Raad
Issam I
II
The M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA. iraad@mdanderson.org
Hachem
Ray Y
RY
Herbrecht
Raoul
R
Graybill
John R
JR
Hare
Roberta
R
Corcoran
Gavin
G
Kontoyiannis
Dimitrios P
DP
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D005670:Fusarium; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B