Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS (Instituto Ramón y Cajal de Investigación Sanitaria), Universidad de Alcalá, Madrid, Spain.
Infectious Diseases Department, Hospital Clínic, IDIBAPS (Institut d'Investigacions biomèdiques Agust Pi i Sunyer), Universitat de Barcelona, Barcelona, Spain.
Mycoses. 2019 Jun;62(6):526-533. doi: 10.1111/myc.12911. Epub 2019 Apr 3.
Posaconazole (PCZ) is used mainly for the prevention of invasive fungal infection (IFI).
A multicentre retrospective, investigational study using a non-randomized, single-arm design carried out in six tertiary hospitals in Spain to evaluate the use of PCZ in different forms of administration in the (non-prophylactic) treatment of IFI.
Over an eight-year-period, 67 patients were included in this study. PCZ was administered as salvage therapy (intolerant or refractory to a previous antifungal agent) in 65/67 (97%); of these, it was used against Aspergillosis (68.6%), Zygomycosis (13.4%), other moulds (8.9%) and yeast (10.5%). The median duration of PCZ therapy was 75 days. The oral solution was associated with low serum levels (<0.7 mg/L) in 63% of available patients. Clinical response at 3 and 12 months of PCZ therapy were for aspergillosis: 47.8% and 41.3%; for zygomycosis: 55.5% and 55.5%; and for other mycoses: 69.2% and 69.2%, respectively. Suspension by toxicity was only observed in 6% and 7.5% of patients at 3 and 12 months, respectively, mainly with grade III/IV elevations of liver function test (LFTs).
Posaconazole salvage therapy, especially oral tablets, can be an effective alternative option for patients with IFI who cannot tolerate or do not respond to other antifungal therapies.
泊沙康唑（PCZ）主要用于预防侵袭性真菌感染（IFI）。
在西班牙的六所三级医院进行了一项多中心回顾性、非随机、单臂设计的研究，以评估 PCZ 在不同给药方式下（非预防性）治疗 IFI 的应用。
在 8 年期间，本研究纳入了 67 例患者。67 例患者中，65 例（97%）接受了泊沙康唑作为挽救治疗（对先前的抗真菌药物不耐受或无效）；其中，用于治疗曲霉病（68.6%）、接合菌病（13.4%）、其他霉菌（8.9%）和酵母（10.5%）。PCZ 治疗的中位持续时间为 75 天。口服溶液在 63%可获得患者中与低血清水平（<0.7mg/L）相关。在接受泊沙康唑治疗 3 个月和 12 个月时，曲霉病的临床反应率分别为 47.8%和 41.3%；接合菌病分别为 55.5%和 55.5%；其他真菌感染分别为 69.2%和 69.2%。仅分别有 6%和 7.5%的患者在第 3 个月和第 12 个月因毒性而停用泊沙康唑悬浮液，主要表现为肝功能试验（LFTs）的 III/IV 级升高。
泊沙康唑挽救治疗，特别是口服片剂，可为不能耐受或对其他抗真菌治疗无反应的 IFI 患者提供有效的替代选择。
