1148. Effectiveness for increasing administration frequency of posaconazole oral suspension to achieve therapeutic serum concentration in Korean patients with hematologic malignancy
Session: Poster Abstract Session: Pharmacological Studies of Antifungals
Friday, October 9, 2015
Room: Poster Hall
Posters
  • posaconazole_IDSA_poster_9_30 WBP.jpg (712.8 kB)
  • Background: Increasing dosage of posaconazole suspension is known to be ineffective for leukemic patients with gastrointestinal disturbance. However, there is a little data about effectiveness for increasing frequency of posaconazole administration, especially in Korean patients to whom high fat meal is not tolerable. The aim of this study is to analyze the impact of increasing frequency of posaconazole administration on achieving therapeutic serum concentration (>500 ng/mL) in Korean adult patients with hematologic malignancy.

    Methods: An observational study was performed in 65 adult patients receiving chemotherapy due to acute myeloid leukemia or myelodysplastic syndrome who initially received posaconazole oral suspension 200 mg orally three times daily for fungal prophylaxis and to whom a bundle approach was applied to maximize drug absorption. Frequency of posaconazole was increased to four times daily when the serum posaconazole level was less than 500 ng/mL on the eighth day after initiation of posaconazole. Follow-up posaconazole serum level was measured on fifteenth day.

    Results: In 26% (14/54), initial steady state concentration was in sub-therapeutic range with 200 mg orally three times daily of posaconazole suspension. After increasing frequency to 200mg four times daily, the median of posaconazole serum concentration was significantly increased from 386 ng/mL (range, 106 - 485 ng/mL) to 548 ng/mL (range, 283 – 1320) (p = 0.001). Seventy-three percent (8/11) patients, who showed the initially sub-therapeutic level, achieved to therapeutic level; whereas all of two patients with initially less than 200 ng/mL failed to reach therapeutic level.

    Conclusion: Dose adjustment of posaconazole suspension by increasing the administration frequency may be effective to achieve therapeutic level in the patients to whom high fat meal is not tolerable.

    Eun Jung Kim, MD1, Kyung-Sang Yu, PhD2, Kyoung-Ho Song, MD1, Pyeong-Gyun Choe, MD1, Ji Whan Bang, MD1, Eu Suk Kim, MD1, Sang-Won Park, MD, PhD1, Soo-Mee Bang, MD, PhD1, Hong Bin Kim, MD, PhD1, Inho Kim, MD, PhD1, Nam-Joong Kim, MD, PhD1, Wan Beom Park, MD, PhD1 and Myoung-Don Oh, MD, PhD1, (1)Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea, (2)Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine, Seoul, South Korea

    Disclosures:

    E. J. Kim, None

    K. S. Yu, None

    K. H. Song, None

    P. G. Choe, None

    J. W. Bang, None

    E. S. Kim, None

    S. W. Park, None

    S. M. Bang, None

    H. B. Kim, None

    I. Kim, None

    N. J. Kim, None

    W. B. Park, None

    M. D. Oh, None

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