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Posaconazole Salvage Treatment for Invasive Fungal Infection

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Abstract

Invasive fungal infection (IFI) is an important cause of morbidity and mortality. Posaconazole is a second generation triazole with a broad spectrum, and it may be suitable for salvage antifungal treatment although posaconazole is not usually considered to be as first-line antifungal therapy for IFI. The purpose of this study was to assess the utility of posaconazole salvage treatment for IFI. We conducted a retrospective review of patients with salvage antifungal treatment with posaconazole for IFI at our institution between December 2007 and July 2012. A total of ten patients received posaconazole salvage IFI. Etiology of IFI was consisting of mucormycosis (four patients), Paecilomyces variotii (one patient), and unspecified IFI etiology (five patients). Causes of posaconazole treatment were following; intolerance of previous antifungal therapy in five patients, refractory IFI on previous antifungal therapy in four patients, and both intolerance of previous antifungal therapy and refractory IFI on previous antifungal therapy in one patient. Duration of posaconazole salvage treatment ranged from 15 to 355 days with median 47 days. The overall successful posaconazole salvage treatment response rate was 80.0 % (8 of 10 patients). There were three patients who died during the study period. However, only one death was attributed to the progression of IFI. Two patients discontinued posaconazole due to adverse events. Posaconazole salvage treatment was effective antifungal therapy for IFI. Further studies are needed to define the optimal therapeutic strategy.

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Acknowlegments

This work was supported by an investigator initiated grant from Merck to JH Kim (MISP 50495).

Conflict of interest

J.H. Kim has received research funding from Merck.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Internal Medicine, University of Utah, SOM 4B319 30 N 1900 E, Salt Lake City, UT, 84132, USA

    Jong Hun Kim

  2. Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, 84112, USA

    Kali Williams

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  1. Jong Hun Kim
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  2. Kali Williams
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Correspondence to Jong Hun Kim.

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Kim, J.H., Williams, K. Posaconazole Salvage Treatment for Invasive Fungal Infection. Mycopathologia 178, 259–265 (2014). https://doi.org/10.1007/s11046-014-9792-y

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  • DOI: https://doi.org/10.1007/s11046-014-9792-y

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