Yonsei Med J.  2013 Sep;54(5):1234-1240. 10.3349/ymj.2013.54.5.1234.

Posaconazole Treatment in Korea: Single-Center Experience Over 5 Years

• Lee HJ
• Kwon JC
• Kim SH
• Choi SM
• Lee DG
• Park SH
• Choi JH
• Yoo JH
• Cho BS
• Lee S
• Kim HJ
• Min CK
• Lee JW
• Min WS

• KMID: 1793173
• DOI: http://doi.org/10.3349/ymj.2013.54.5.1234

Abstract

PURPOSE
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.
MATERIALS AND METHODS
Data from patients who received posaconazole treatment at Catholic Blood and Marrow Transplantation Center were retrospectively reviewed between January 2007 and September 2012.
RESULTS
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.
CONCLUSION
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.

Keyword

Immunocompromised host; mucormycosis; posaconazole; salvage therapy

MeSH Terms

Adult
Aged
Antifungal Agents/adverse effects/*therapeutic use
Female
Humans
Immunocompromised Host
Male
Middle Aged
Mucormycosis/drug therapy
Mycoses/*drug therapy
Republic of Korea
Salvage Therapy/adverse effects
Triazoles/adverse effects/*therapeutic use
Antifungal Agents
Triazoles

Figure

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  Fig. 1 The chest computed tomography of patient No. 5 shows two, round consolidations with surrounding grounding glass opacities in the right upper lobe: (A) at the time of diagnosis of fungal pneumonia, (B) 2 weeks later, (C) 6 months later.

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  Fig. 2 The chest computed tomography of patient No. 6 shows necrotizing pneumonia: (A) superior segment of the right lower lobe at the time of diagnosis of pulmonary mucormycosis, (B) subpleural portion of the right lower lobe at the time of diagnosis of pulmonary mucormycosis, (C) 6 months later.

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