Crushed posaconazole delayed-release tablets for antifungal prophylaxis and treatment in children

Weerdenburg, H; Gwee, A; Haeusler, GM; Osowicki, J; Boast, A

Author(s): Weerdenburg, H; Gwee, A; Haeusler, GM; Osowicki, J; Boast, A;
Details: Publication Year 2024-12-02,Volume 79,Issue #12,Page 3340-3343
Journal Title: Journal of Antimicrobial Chemotherapy
Publication Type: Research article
Abstract: OBJECTIVES: Therapeutic drug monitoring (TDM) is recommended for posaconazole to achieve target concentrations of ≥0.7 mg/L and ≥1.0 mg/L for prophylaxis and treatment of invasive fungal infection (IFI), respectively. However, target attainment is challenging with the oral suspension, particularly in children. Here, we describe our experience using crushed delayed-release tablet (DRT) in a paediatric cohort, with a focus on TDM. METHODS: We undertook a retrospective audit of crushed posaconazole DRT administration via enteral feeding tubes (EFTs) for patients aged ≤18 years over 18 months at The Royal Children's Hospital Melbourne who had at least one trough concentration measured at steady state. Details of patient demographics, posaconazole dosing, monitoring and adverse effects were recorded. RESULTS: Twelve patients with a median age of 9 years (range 2 to 14) received posaconazole DRT via EFT for prophylaxis (n = 8) or treatment (n = 4). All children achieved target concentration, with a median dose of 7 mg/kg/day (range 5 to 11) for prophylaxis and 13 mg/kg/day (range 9 to 20) for treatment. The median time to reach therapeutic levels was 7 days (range 5 to 14) for prophylaxis and 20 days (range 15 to 35) for treatment. One child had blockage of their EFT, which was attributed to posaconazole. No other adverse effects were observed. CONCLUSIONS: Crushed posaconazole DRT administered via EFT may be used as a method of attaining therapeutic posaconazole concentrations in children for antifungal prophylaxis and treatment.
Publisher: Oxford University Press
Keywords: Humans; *Triazoles/administration & dosage/pharmacokinetics; *Antifungal Agents/administration & dosage/pharmacokinetics; Child; Adolescent; Male; Retrospective Studies; Female; Child, Preschool; *Tablets; *Delayed-Action Preparations; *Drug Monitoring; Invasive Fungal Infections/prevention & control/drug therapy; Administration, Oral
Department(s): Infectious Diseases
Publisher's Version: https://doi.org/10.1093/jac/dkae373
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-01-09 06:35:17

Last Modified: 2025-01-09 06:41:23