Publication: Activity of posaconazole in the treatment of central nervous system fungal infections
Issued Date
2005-10-01
Resource Type
ISSN
14602091
03057453
03057453
Other identifier(s)
2-s2.0-27144459842
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Antimicrobial Chemotherapy. Vol.56, No.4 (2005), 745-755
Suggested Citation
Punnee Pitisuttithum, Ricardo Negroni, John R. Graybill, Beatriz Bustamante, Peter Pappas, Stanley Chapman, Roberta S. Hare, Catherine J. Hardalo Activity of posaconazole in the treatment of central nervous system fungal infections. Journal of Antimicrobial Chemotherapy. Vol.56, No.4 (2005), 745-755. doi:10.1093/jac/dki288 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/16816
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Activity of posaconazole in the treatment of central nervous system fungal infections
Abstract
Objectives: A multinational, multicentre, open-label clinical trial was conducted to evaluate the safety and efficacy of posaconazole, an extended-spectrum triazole antifungal agent, in subjects with invasive fungal infections who had refractory disease or who were intolerant of standard antifungal therapy. In this subanalysis, we report on those subjects in this trial who had a fungal infection that involved the CNS. Methods: Subjects received posaconazole oral suspension 800 mg/day in divided doses for up to 1 year; however, subjects could receive additional therapy as part of a treatment-use extension protocol. A blinded, third-party data review committee determined subject eligibility and outcome. Results: Of the 330 subjects who enrolled in the study, 53 had infections of the CNS, of which 39 were considered evaluable for efficacy. Most had refractory disease (37 of 39) and underlying HIV infection (29 of 39). Twenty-nine subjects had cryptococcal infections, and 10 had infections caused by other fungal pathogens [Aspergillusspp. (four), Pseudallescheria boydii (two), Coccidioides immitis (one), Histoplasma capsulatum (one), Ramichloridium mackenziei (one), and Apophysomyces elegans plus a Basidiomycetessp. (one)]. Successful outcomes were observed in 14 of 29 (48%) subjects with cryptococcal meningitis and five of 10 (50%) subjects with CNS infections due to other fungal pathogens. Posaconazole was well tolerated. Conclusions: These data suggest that posaconazole, as an oral medication, has clinical activity against fungal infections of the CNS and may provide a valuable alternative to parenteral therapy in patients failing existing antifungal agents. © The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.