title: Significance of monitoring trough plasma concentration levels for invasive fungal infection prophylaxis with itraconazole oral solution in patients with hematological malignancies: a prospective study.
abstract: In this prospective study, we examined the prophylactic effect of itraconazole oral solution (ITCZ-OS) against invasive fungal disease in hematologic malignancy patients. The participants were 36 patients, at least 16 years of age, with hematologic malignancies treated at our hospital. ITCZ-OS 200 mg/day was administered orally twice a day with a target trough plasma concentration of 350 ng/ml. If the patient did not achieve the target trough plasma concentration, the dose was increased. The success rate of achieving the target trough plasma concentration of ITCZ with a dose of 200 mg/day was 63.9%. During the observation period, 2 patients (5.6%) were diagnosed with possible invasive fungal disease according to the EORTC/MSG 2008 criteria. Adverse events were observed in 2 patients (5.6%). The results showed administration of ITCZ-OS while monitoring ITCZ trough plasma concentrations to be effective for preventing invasive fungal disease, and no serious adverse events occurred. Since predicting trough levels in response to ITCZ administrations is difficult, its measurement is necessary to maintain the prophylactic effect of ITCZ.
authors.affiliation: Department of Hematology, Hamanomachi Hospital.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawano
authors.forename: Kana
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Jiromaru
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Jinnochi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Semba
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugio
authors.forename: Keiji
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Saito
authors.forename: Shuro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Hideho
authors.initials: H
authors.lastname: Henzan
authors.forename: Ken
authors.initials: K
authors.lastname: Takase
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Morita
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood / Q000517:prevention & control*; D009190:Myelodysplastic Syndromes / Q000628:therapy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole