Publication: Pharmacokinetic/pharmacodynamic study of posaconazole delayed-release tablet in a patient with coexisting invasive aspergillosis and mucormycosis
1
Issued Date
2019-01-01
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ISSN
1178203X
11766336
11766336
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2-s2.0-85070241733
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Mahidol University
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SCOPUS
Bibliographic Citation
Therapeutics and Clinical Risk Management. Vol.15, (2019), 589-595
Suggested Citation
Pannee Leelawattanachai, Preecha Montakantikul, Wichit Nosoongnoen, Methee Chayakulkeeree Pharmacokinetic/pharmacodynamic study of posaconazole delayed-release tablet in a patient with coexisting invasive aspergillosis and mucormycosis. Therapeutics and Clinical Risk Management. Vol.15, (2019), 589-595. doi:10.2147/TCRM.S203625 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/50540
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Title
Pharmacokinetic/pharmacodynamic study of posaconazole delayed-release tablet in a patient with coexisting invasive aspergillosis and mucormycosis
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Abstract
© 2019 Leelawattanachai et al. Limited information exists regarding the optimal dose of posaconazole delayedrelease tablet for the treatment of invasive mold infection. Here, we report the case of a previously healthy 44-year-old Thai man who developed coexisting invasive pulmonary aspergillosis and mucormycosis following a car accident. He was treated with posaconazole delayed-release tablet. This report describes the pharmacokinetic/pharmacodynamic study, safety profile, and determination of the appropriate dosage of posaconazole delayed-release tablet in a patient with coexisting invasive aspergillosis and mucormycosis. Posaconazole exposure was analyzed by noncompartmental model. Ratio of area under the plasma concentration- time curve over the minimum inhibitory concentration (AUC/MIC) was applied to maximize the efficacy of posaconazole. The loading dose of 300 mg q 12 hrs was found to be potentially insufficient for achieving the AUC/MIC target for treatment of invasive mold infection with minimum inhibitory concentrations >0.01 mg/L. Early therapeutic drug monitoring to detect the drug concentration of posaconazole delayed-release tablet is necessary so that dosing adjustments can be made, as needed. In addition, a maintenance dose of either 400 or 300 mg once daily could achieve the AUC/MIC targets. These maintenance dosing regimens effectuated a successful clinical outcome with minimal adverse events.