Posaconazole: the case for therapeutic drug monitoring.
Invasive fungal infections are associated with high morbidity and mortality. Antifungal therapeutic options remain relatively limited; therefore, optimization of present regimens is essential. Posaconazole is licensed for prevention of invasive fungal infections and oropharyngeal candidiasis and salvage therapy for invasive aspergillosis. Recent data suggest that therapeutic drug monitoring may be an important tool for patient management. Clinical and laboratory animal data suggest that posaconazole demonstrates clinically relevant exposure-response relationships. Higher systemic drug exposure is associated with improved clinical outcomes. Potentially subtherapeutic concentrations are frequently encountered in critically ill patients. Therapeutic drug monitoring provides a way to optimize the use of posaconazole, and this review summarizes the indications and process by which this can be achieved.
School of Translational Medicine, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom. sue.howard@manchester.ac.uk
Susan J
SJ
Howard
Timothy W
TW
Felton
Alicia
A
Gomez-Lopez
William W
WW
Hope
D000935:Antifungal Agents / Q000097:blood* / Q000493:pharmacokinetics*; D016903:Drug Monitoring; D006801:Humans; D009181:Mycoses / Q000517:prevention & control; D014230:Triazoles / Q000097:blood* / Q000493:pharmacokinetics*
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole