Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea.
Yonsei Med J. 2013 Sep;54(5):1234-40. doi: 10.3349/ymj.2013.54.5.1234.
Posaconazole is a second-generation triazole with a broad spectrum. However, there is a lack of data to support a significant role for posaconazole in the treatment of invasive fungal infection (IFI), especially in Korea. Until recently, posaconazole was available only through the Korean Orphan Drug Center. This study was designed to review the use of posaconazole at a single-center in Korea.
Data from patients who received posaconazole treatment at Catholic Blood and Marrow Transplantation Center were retrospectively reviewed between January 2007 and September 2012.
A total of 11 cases (3 males and 8 females, median age 52 years) received posaconazole. Five patients were given the drug for mucormycosis, two for invasive aspergillosis, and four for unspecified IFI for which galactomannan (GM) assays were negative. The treatment duration ranged from 4-250 days. Three patients received posaconazole for management refractory IFI, two for intolerance of previous antifungal therapy, and six for long-term maintenance treatment. The overall successful response rate to posaconazole was 55% (six of eleven patients). Five of eleven patients died during the study period. However, only one death was attributed to the progression of IFI. None of the patients discontinued posaconazole therapy due to adverse events.
Posaconazole is an attractive oral antifungal agent for salvage treatment of IFI, particularly upon diagnosis of mucormycosis or in cases in which mucormycosis cannot be ruled out due to a negative GM.
泊沙康唑是一种具有广谱作用的第二代三唑类药物。然而,在治疗侵袭性真菌感染(IFI)方面,尤其是在韩国,缺乏数据支持泊沙康唑发挥重要作用。直到最近,泊沙康唑才通过韩国孤儿药中心获得供应。本研究旨在回顾韩国某单一中心使用泊沙康唑的情况。
回顾性分析 2007 年 1 月至 2012 年 9 月期间在天主教血液和骨髓移植中心接受泊沙康唑治疗的患者数据。
共有 11 例患者(3 例男性,8 例女性,中位年龄 52 岁)接受了泊沙康唑治疗。5 例患者因毛霉病接受该药治疗,2 例因侵袭性曲霉病,4 例因 GM 检测阴性的不明原因 IFI。治疗持续时间为 4-250 天。3 例患者因 IFI 难治性接受泊沙康唑治疗,2 例因对先前抗真菌治疗不耐受,6 例因长期维持治疗。泊沙康唑总体治疗成功率为 55%(11 例中的 6 例)。研究期间,11 例患者中有 5 例死亡。然而,只有 1 例死亡归因于 IFI 的进展。没有患者因不良反应而停止泊沙康唑治疗。
泊沙康唑是治疗 IFI 的一种有吸引力的口服抗真菌药物,特别是在毛霉病诊断时,或因 GM 检测阴性而不能排除毛霉病时。