title: Posaconazole: when and how? The clinician's view.
abstract: Posaconazole is the newest triazole antifungal agent available as an oral suspension with an extended spectrum of activity against Candida species, Aspergillus species, Cryptococcus neoformans, Zygomycetes and endemic fungi. Among posaconazole advantages are the relatively low potential of cross-resistance with other azoles, few drug interactions compared with other azoles and its activity against Zygomycetes. Randomised, double-blind trials have shown that posaconazole is effective for prophylaxis against invasive fungal infections (IFI), especially aspergillosis, in high-risk patients. Results of Phase III clinical trials and case/series reports indicate that posaconazole is effective in treating oesophageal candidiasis, including azole-refractory disease, and other IFI refractory to standard antifungal therapies. To date, posaconazole has appeared to be well tolerated even in long-term courses; it has an excellent safety profile with gastrointestinal disturbances being the most common adverse events reported. The dose of posaconazole is 200 mg three times daily for prophylaxis, 800 mg daily in two or four divided doses for the treatment of IFI and 100 mg daily (200 mg loading dose) for the treatment of oropharyngeal candidiasis. On the basis of early clinical experience, it appears that posaconazole will be a valuable aid in the management of life-threatening fungal infections.
authors.affiliation: 3rd Department of Pediatrics, Aristotle University Medical School, Hippokration Hospital, Thessaloniki, Greece.
authors.forename: Aspasia
authors.initials: A
authors.lastname: Katragkou
authors.forename: Fotini
authors.initials: F
authors.lastname: Tsikopoulou
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
authors.forename: Theoklis E
authors.initials: TE
authors.lastname: Zaoutis
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D001230:Aspergillus / Q000187:drug effects; D002175:Candida / Q000187:drug effects; D058365:Candidiasis, Invasive / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D017326:Clinical Trials, Phase III as Topic; D003453:Cryptococcosis / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D003455:Cryptococcus neoformans / Q000187:drug effects; D004334:Drug Administration Schedule; D004347:Drug Interactions; D006801:Humans; D008826:Microbial Sensitivity Tests; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole