Posaconazole in lung transplant recipients: use, tolerability, and efficacy

Robinson, C. L., Chau, C., Yerkovich, S. T., Azzopardi, M., Hopkins, P. and Chambers, D. (2016) Posaconazole in lung transplant recipients: use, tolerability, and efficacy. Transplant Infectious Disease, 18 2: 302-308. doi:10.1111/tid.12497

Author Robinson, C. L.
Chau, C.
Yerkovich, S. T.
Azzopardi, M.
Hopkins, P.
Chambers, D.
Title Posaconazole in lung transplant recipients: use, tolerability, and efficacy
Journal name Transplant Infectious Disease   Check publisher's open access policy
ISSN 1399-3062
Publication date 2016-04-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/tid.12497
Volume 18
Issue 2
Start page 302
End page 308
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Background: Fungal infection is a common cause of mortality and morbidity in lung transplant recipients (LuTR). Treatment failure to first-line antifungals because of resistance or intolerance is an increasing problem. Posaconazole (PCZ), a triazole antifungal, is an attractive treatment option.

Methods: We performed a single-center retrospective study to describe the use, tolerability, efficacy, and drug interaction effect (with tacrolimus) of PCZ oral suspension in LuTR.

Results: Seventy-eight patients were treated with PCZ oral suspension for prophylaxis (n = 15), pre-emptive treatment (n = 31), and treatment of possible (n = 7) and probable (n = 25) invasive fungal infection. A range of fungal isolates was encountered. Resolution was observed in 52.4% (probable, possible, and pre-emptive treatment groups). Aggregate all-cause 1-year mortality was 12.8%. PCZ was well tolerated with 11.5% of patients experiencing adverse effects. Despite dose adjustment strategies, 11.7% of patients experienced supratherapeutic tacrolimus levels, which in 5 cases was associated with a rise (mean 21.6 μmol/L) in serum creatinine.

Conclusions: PCZ is well tolerated and appears effective in the management of fungal infection after lung transplantation. Patients receiving concurrent tacrolimus require careful therapeutic drug monitoring.
Keyword Fungal infection
Lung transplant
Tacrolimus interaction
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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