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Observational Study
. 2022 Jun;65(6):656-660.
doi: 10.1111/myc.13446. Epub 2022 Apr 28.

Exposure to intravenous posaconazole in critically ill patients with influenza: A pharmacokinetic analysis of the POSA-FLU study

Ruth Van Daele  1 , Joost Wauters  2 , Erwin Dreesen  3 , Jerina Boelens  4 , Eric Nulens  5 , Piet Lormans  6 , Lore Vanderbeke  2 , Cato Jacobs  7 , Bart Rijnders  8 , Paul E Verweij  9 , Roger J Brüggemann  10 , Isabel Spriet  1
Affiliations
Observational Study

Exposure to intravenous posaconazole in critically ill patients with influenza: A pharmacokinetic analysis of the POSA-FLU study

Ruth Van Daele et al. Mycoses. 2022 Jun.

Abstract

Background: Data on posaconazole in the critically ill are scarce. In the POSA-FLU study, we examined the prevention of influenza-associated pulmonary aspergillosis with posaconazole in this population.

Methods: In this observational sub-study, we performed a pharmacokinetic analysis, including protein binding and target attainment (TA). Blood samples were collected over a 24 h-dosing interval on both an early (Day 2 or 3) and a later (≥Day 4) treatment day.

Results: Target attainment was shown for AUC0-24 and Cmin prophylaxis but not for Cmin treatment. Moreover, a saturable protein binding with a significant, positive relationship between albumin concentrations and the maximum binding capacity was observed.

Conclusions: Our analysis indicates that posaconazole may be a suitable drug to further investigate for prophylaxis, as TA for prophylaxis was reached. Exposure targets for treatment were insufficiently attained in this population.

Keywords: critically ill patients; exposure; posaconazole; target attainment; unbound concentrations.

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References

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