Aim: Invasive fungal infections pose a severe health threat to patients. Despite recent advances in drug development, treatment of recurrent fungal infections remains difficult. Posaconazole is a broad-spectrum triazole antifungal drug available for oral administration. Although initial studies have described its use in treating various fungal infections, its efficacy and safety in patients with invasive fungal infections remains to be further confirmed. Materials & Methods: In this study, we performed a multicenter, open-label clinical trial of posaconazole oral suspension in the treatment of 63 patients with invasive fungal infections who were refractory to or intolerant of first-line therapy. Results: Our result showed that 64.4% of patients had a clinical response after posaconazole treatment, with 52.9% showing eradication of the fungal infection. The treatment caused some adverse effects of mild or moderate severity that were of short duration. Conclusion: The results of this trial indicate that posaconazole can be used in invasive fungal infections as an alternative or salvage therapy.

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References

1 Warnock DW. Trends in the epidemiology of invasive fungal infections. Nippon Ishinkin Gakkai Zasshi48(1),1–12 (2007).
MedlineGoogle Scholar
2 Cornely OA. Aspergillus to Zygomycetes: causes, risk factors, prevention, and treatment of invasive fungal infections. Infection36(4),296–313 (2008).
Medline CASGoogle Scholar
3 Mishra NN, Prasad T, Sharma N et al. Pathogenicity and drug resistance in Candida albicans and other yeast species. A review. Acta Microbiol. Immunol. Hung.54(3),201–235 (2007).
Medline CASGoogle Scholar
4 Rees JR, Pinner RW, Hajjeh RA, Brandt ME, Reingold AL. The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992–1993: results of population-based laboratory active surveillance. Clin. Infect. Dis.27(5),1138–1147 (1998).
Medline CASGoogle Scholar
5 Sabatelli F, Patel R, Mann PA et al.In vitro activities of posaconazole, fluconazole, itraconazole, voriconazole and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob. Agents Chemother.50(6),2009–2015 (2006).
Medline CASGoogle Scholar
6 Ellis D, Amphotericin B: spectrum and resistance. J. Antimicrob. Chemother.49(Suppl. 1),7–10 (2002).
Medline CASGoogle Scholar
7 Gallis HA, Drew RH, Pickard WW. Amphotericin B: 30 years of clinical experience. Rev. Infect. Dis.12(2),308–329 (1990).
Medline CASGoogle Scholar
8 Gallagher JC, MacDougall C, Ashley ES, Perfect JR. Recent advances in antifungal pharmacotherapy for invasive fungal infections. Expert Rev. Anti. Infect. Ther.2(2),253–268 (2004).
Medline CASGoogle Scholar
9 Boucher HW, Groll AH, Chiou CC, Walsh TJ. Newer systemic antifungal agents: pharmacokinetics, safety and efficacy. Drugs64(18),1997–2020 (2004).
Medline CASGoogle Scholar
10 Ascioglu S, Rex JH, de Pauw B et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin. Infect. Dis.34(1),7–14 (2002).
Medline CASGoogle Scholar
11 Raad II, Hanna HA, Boktour M et al. Novel antifungal agents as salvage therapy for invasive aspergillosis in patients with hematologic malignancies: posaconazole compared with high-dose lipid formulations of amphotericin B alone or in combination with caspofungin. Leukemia22,496–503 (2008).
Medline CASGoogle Scholar
12 Tobon AM, Correa AL, Arango M, de Bedout C, Restrepo A. Posaconazole therapy for severe abdominal candidiasis: a case report. Rev. Iberaom. Micol.21(2),79–81 (2004).
MedlineGoogle Scholar
13 Hachem RY, Langston AA, Graybill JR et al. Posaconazole as salvage treatment of invasive fungal infections in patients with underlying renal impairment. J. Antimicrob. Chemother.62(6),1386–1391 (2008).
Medline CASGoogle Scholar
14 Herbrecht R, Kessler R, Kravanja C, Meyer MH, Waller J, Letscher-Bru V. Successful treatment of Fusarium proliferatum pneumonia with posaconazole in a lung transplant recipient. J. Heart Lung Transplant.23(12),1451–1454 (2004).
MedlineGoogle Scholar
15 Torres HA, Hachem RY, Chemaly RF, Kontoyiannis DP, Raad II. Posaconazole: a broad spectrum triazole antifungal. Lancet Infect. Dis.5(12),775–785 (2005).
Medline CASGoogle Scholar
16 Walsh TJ, Raad I, Patterson TF et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin. Infect. Dis.44(1),2–12 (2007).
Medline CASGoogle Scholar
101 Clinical trials database. Trial no: CT00811642. www.clinicaltrials.gov/ct2/show/NCT00811642
Google Scholar

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Published online 10 February 2012

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Financial & competing interests disclosure

This study was supported by Schering-Plough Corporation, now Merck & Co., Inc., Whitehouse Station, NJ, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors were responsible for the preparation of this manuscript. Editorial assistance was provided by Content Ed Net, Shanghai Co. Ltd.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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