title: [Level of evidence for therapeutic drug monitoring of posaconazole].
abstract: Posaconazole, systemic antifungal marketed in France since 2006, is indicated as second line in curative treatment of invasive fungal infections (IFI) (aspergillosis...) and prophylaxis of IFI in patients receiving chemotherapy or hematopoietic stem cell transplantation. The analysis of the literature indicates a concentration-efficacy relationship, but to date, no study has been able to show a concentration-toxicity correlation due to its favourable safety profile and the difficulty to obtain high concentrations. In curative, maintenance of trough plasma concentrations between 0.5 and 1.5 mg/L seems to be associate with an efficacy. In prophylaxis, a threshold of 0.5 mg/L corresponds to a minimal exposure. However this target is not yet well defined. Saturation of absorption above the 800 mg oral dose limits the adjustment of concentrations. As such, the Therapeutic Drug Monitoring of posaconazole can be recommended.
authors.affiliation: Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Lefeuvre
authors.forename: Mohammed-Larbi
authors.initials: ML
authors.lastname: Jelassi
authors.forename: Amine
authors.initials: A
authors.lastname: Benlmouden
authors.forename: Maud
authors.initials: M
authors.lastname: Berge
authors.forename: Chantal
authors.initials: C
authors.lastname: Le Guellec
authors.forename: Eliane M
authors.initials: EM
authors.lastname: Billaud
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry* / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000517:prevention & control; D013056:Spectrophotometry, Ultraviolet; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry* / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole