Single-centre study of therapeutic drug monitoring of posaconazole in lung transplant recipients: factors affecting trough plasma concentrations

Jeong W 1 , Snell GI 2 , Levvey BJ 2 , Westall GP 2 , Morrissey CO 3 , Wolfe R 4 Show all authors , Ivulich S 5 , Neoh CF 6 , Slavin MA 7 , Kong DCM 1

Affiliations 

  • 1 Centre for Medicine Use and Safety, Monash University, Victoria, Australia
  • 2 Lung Transplant Service, Alfred Health & Monash University, Victoria, Australia
  • 3 Department of Infectious Diseases, Alfred Health & Monash University, Victoria, Australia
  • 4 Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
  • 5 Pharmacy Department, Alfred Health, Victoria, Australia
  • 6 Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA, Selangor, Malaysia
  • 7 National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Victoria, Australia
J Antimicrob Chemother, 2018 Mar 01;73(3):748-756.
PMID: 29211913 DOI: 10.1093/jac/dkx440

Abstract

Objectives: 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).

Methods: A single-centre, retrospective study evaluating posaconazole Cmin in LTx recipients receiving posaconazole suspension or MR tablets between January 2014 and December 2016.

Results: 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 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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