Posaconazole liquid suspension in solid organ transplant recipients previously treated with voriconazole

Research output: Contribution to journalArticle

Abstract

Background: Posaconazole (PCZ) has become an attractive alternative to voriconazole (VCZ) in transplant recipients with suspected or proven invasive filamentous fungal infections, causing fewer drug interactions. Here, we describe our experience with PCZ after VCZ in solid organ transplant (SOT) recipients. Methods: VCZ was replaced by PCZ liquid solution in 19 SOT recipients (15 lung, 2 kidney, 1 liver, and 1 heart/lung) with invasive pulmonary aspergillosis (12/19; 63.2%), possible invasive pulmonary fungal infection (2/19; 10.5%), prophylaxis (2/19; 10.5%), or pulmonary scedosporiosis, mucormycosis, and mixed fungal species (1 each). Rationales for switch were suspected adverse reactions to VCZ (17/19; 89.4%) and desire to broaden spectrum of coverage to include agents of mucormycosis (3/19; 15.8%). Results: PCZ was well tolerated in all patients. In those patients with baseline liver enzyme abnormalities, a median change occurred in concentrations of alanine transaminase (-20 IU/L), aspartate aminotransferase (-17.5 IU/L), and alkaline phosphatase (-61.5 IU/L). Clinical success (resolution, stabilization, or prevention of infection) was achieved in 16/19 (84%) people. Conclusion: PCZ appears to have a reasonable safety and tolerability profile and may be an effective alternative in SOT patients who require an agent with anti-mold activity, but are unable to tolerate VCZ.

Original languageEnglish (US)
Pages (from-to)493-496
Number of pages4
JournalTransplant Infectious Disease
Volume17
Issue number3
DOIs
StatePublished - Jun 1 2015

Keywords

  • Fungal infection prevention
  • Posaconazole
  • Solid organ transplant
  • Voriconazole

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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