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Posaconazole exposure in critically ill ICU patients: a need for action

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Posaconazole exposure in critically ill ICU patients: a need for action. / König, Christina; Göpfert, Melanie; Kluge, Stefan; Wichmann, Dominic.

In: INFECTION, Vol. 51, No. 6, 12.2023, p. 1767-1772.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

König, C, Göpfert, M, Kluge, S & Wichmann, D 2023, 'Posaconazole exposure in critically ill ICU patients: a need for action', INFECTION, vol. 51, no. 6, pp. 1767-1772. https://doi.org/10.1007/s15010-023-02078-9

APA

König, C., Göpfert, M., Kluge, S., & Wichmann, D. (2023). Posaconazole exposure in critically ill ICU patients: a need for action. INFECTION, 51(6), 1767-1772. https://doi.org/10.1007/s15010-023-02078-9

Vancouver

König C, Göpfert M, Kluge S, Wichmann D. Posaconazole exposure in critically ill ICU patients: a need for action. INFECTION. 2023 Dec;51(6):1767-1772. https://doi.org/10.1007/s15010-023-02078-9

Bibtex

@article{55208413cadd45f7b46fb7973023f32e,
title = "Posaconazole exposure in critically ill ICU patients: a need for action",
abstract = "PURPOSE: Posaconazole is an antifungal drug currently being used for prophylaxis and treatment of invasive fungal infections such as aspergillosis. To date, therapeutic drug monitoring (TDM) of posaconazole is recommended with the use of oral suspension, but the potential need of TDM with the use of IV formulations is rising. Therefore, we aimed to investigate the pharmacokinetics of IV posaconazole in critically ill patients.METHODS: In a prospective study, we analysed 168 consecutivelly collected posaconazole levels from 10 critically ill patients drawn during a 7 day curse. Posaconazole concentrations were measured using a chromatographic method. Demographic and laboratory data were collected, and the data was analysed using descriptive statistics.RESULTS: We included 168 posaconazole levels, resulting in a median trough of 0.62 [0.29-1.05] mg/L with 58% not reaching the suggested target of 0.5 mg/L for fungal prophylaxis. Moreover, 74% of the trough levels were under the target of 1 mg/L which is proposed for the treatment of aspergillosis.CONCLUSION: Posaconazole exposure is highly variable in critically ill patients resulting in potentially insufficient drug concentrations in many cases. TDM is highly recommended to identify and avoid underexposure.TRIAL REGISTRATION NUMBER: NCT05275179, March 11, 2022.",
author = "Christina K{\"o}nig and Melanie G{\"o}pfert and Stefan Kluge and Dominic Wichmann",
year = "2023",
month = dec,
doi = "10.1007/s15010-023-02078-9",
language = "English",
volume = "51",
pages = "1767--1772",
journal = "INFECTION",
issn = "0300-8126",
publisher = "Urban und Vogel",
number = "6",

}

RIS

TY - JOUR

T1 - Posaconazole exposure in critically ill ICU patients: a need for action

AU - König, Christina

AU - Göpfert, Melanie

AU - Kluge, Stefan

AU - Wichmann, Dominic

PY - 2023/12

Y1 - 2023/12

N2 - PURPOSE: Posaconazole is an antifungal drug currently being used for prophylaxis and treatment of invasive fungal infections such as aspergillosis. To date, therapeutic drug monitoring (TDM) of posaconazole is recommended with the use of oral suspension, but the potential need of TDM with the use of IV formulations is rising. Therefore, we aimed to investigate the pharmacokinetics of IV posaconazole in critically ill patients.METHODS: In a prospective study, we analysed 168 consecutivelly collected posaconazole levels from 10 critically ill patients drawn during a 7 day curse. Posaconazole concentrations were measured using a chromatographic method. Demographic and laboratory data were collected, and the data was analysed using descriptive statistics.RESULTS: We included 168 posaconazole levels, resulting in a median trough of 0.62 [0.29-1.05] mg/L with 58% not reaching the suggested target of 0.5 mg/L for fungal prophylaxis. Moreover, 74% of the trough levels were under the target of 1 mg/L which is proposed for the treatment of aspergillosis.CONCLUSION: Posaconazole exposure is highly variable in critically ill patients resulting in potentially insufficient drug concentrations in many cases. TDM is highly recommended to identify and avoid underexposure.TRIAL REGISTRATION NUMBER: NCT05275179, March 11, 2022.

AB - PURPOSE: Posaconazole is an antifungal drug currently being used for prophylaxis and treatment of invasive fungal infections such as aspergillosis. To date, therapeutic drug monitoring (TDM) of posaconazole is recommended with the use of oral suspension, but the potential need of TDM with the use of IV formulations is rising. Therefore, we aimed to investigate the pharmacokinetics of IV posaconazole in critically ill patients.METHODS: In a prospective study, we analysed 168 consecutivelly collected posaconazole levels from 10 critically ill patients drawn during a 7 day curse. Posaconazole concentrations were measured using a chromatographic method. Demographic and laboratory data were collected, and the data was analysed using descriptive statistics.RESULTS: We included 168 posaconazole levels, resulting in a median trough of 0.62 [0.29-1.05] mg/L with 58% not reaching the suggested target of 0.5 mg/L for fungal prophylaxis. Moreover, 74% of the trough levels were under the target of 1 mg/L which is proposed for the treatment of aspergillosis.CONCLUSION: Posaconazole exposure is highly variable in critically ill patients resulting in potentially insufficient drug concentrations in many cases. TDM is highly recommended to identify and avoid underexposure.TRIAL REGISTRATION NUMBER: NCT05275179, March 11, 2022.

U2 - 10.1007/s15010-023-02078-9

DO - 10.1007/s15010-023-02078-9

M3 - SCORING: Journal article

C2 - 37498488

VL - 51

SP - 1767

EP - 1772

JO - INFECTION

JF - INFECTION

SN - 0300-8126

IS - 6

ER -