Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1123
Title: Single-centre study of therapeutic drug monitoring of posaconazole in lung transplant recipients: factors affecting trough plasma concentrations
Author: Jeong, Wirawan
Snell, Gregory, I.
Levvey, Bronwyn J.
Westall, Glen P.
Morrissey, C. Orla
Wolfe, Rory
Ivulich, Steven
Neo, Chin Fen
Slavin, Monica A.
Kong, David C.M.
Issue Date: 2018
Publication Title: Journal of Antimicrobial Chemotherapy
Volume: 73
Issue: 3
Start Page: 748
End Page: 756
Abstract: This study describes therapeutic drug monitoring (TDM) of posaconazole suspension and modified release (MR) tablets in lung transplant (LTx) recipients and evaluates factors that may affect posaconazole trough plasma concentration (Cmin). A single-centre, retrospective study evaluating posaconazole Cmin in LTx recipients receiving posaconazole suspension or MR tablets between January 2014 and December 2016. Forty-seven LTx patients received posaconazole suspension, and 78 received the MR tablet formulation; a total of 421 and 617 Cmin measurements were made, respectively. Posaconazole was concurrently administered with proton pump inhibitor in ≥ 90% of patients. The median (IQR) of initial posaconazole Cmin following 300 mg daily of posaconazole tablet was significantly higher than that of 800 mg daily of posaconazole suspension [1.65 (0.97–2.13) mg/L versus 0.81 (0.48–1.15) mg/L, P < 0.01]. Variability in posaconazole Cmin was apparent regardless of the formulations prescribed and dose adjustments were routinely undertaken to maintain therapeutic Cmin. A clear dose–response relationship was observed in patients receiving posaconazole MR tablets. Non-specific adverse events (fatigue, tremor, lethargy, sweating, nausea/vomiting and weight loss) were reported in 3/78 (4%) patients receiving posaconazole MR tablets. Posaconazole Cmin in these three patients was determined to be 9.6, 6.2 and 2.3 mg/L. The current study has provided clinically important insights into the TDM of posaconazole in LTx recipients. Routine TDM should be undertaken in LTx recipients receiving posaconazole suspension and/or MR tablets.
URI: http://hdl.handle.net/11054/1123
ISSN: 0305-7453
DOI: 10.1093/jac/dkx440
Internal ID Number: 01111
Health Subject: POSACONAZOLE
TROUGH CONCENTRATION
DRUG MONITORING
SUSPENSION
THERAPEUTIC DRUG MONITORING
TABLET DOSAGE FORM
LUNG TRANSPLANTATION
RETROSPECTIVE STUDIES
Type: Journal Article
Article
Appears in Collections:Research Output

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