Methods: A retrospective chart review was conducted on all inpatients that received PCZ for either treatment or prophylaxis from July 1, 2014 through December 31, 2014. Baseline demographics including comorbid conditions, indication, and dose of therapy were collected. Serum concentrations were considered appropriate if they were collected after at least 7 days of consecutive therapy.
Results: Fifty-seven patients received PCZ during the study period. The most frequent underlying medical conditions were bone-marrow transplant (35%), leukemia (28%), and solid organ transplantation (26%). Prophylaxis was the most common indication for use (61.4%). 22 patients received PCZ for treatment; organisms most commonly isolated included aspergillus (n=7), histoplasmosis (n=2), and mucormycosis (n=1). A total of 35 levels were collected during the study period (DRT n=18, OS n=17). The median daily dose was 300 mg for DRT and 600 mg for OS. Median serum concentrations (IQR) were significantly higher with the DRT [2.1 μg/mL (1.28-2.95)] vs. the OS [0.9 μg/mL (0.2-1.25)] (p<0.001). Patients receiving the DRT had levels within the therapeutic range (>0.7 μg/mL) 100% of the time compared to 58.8% in those receiving the OS. No difference was seen in serum concentrations at 300 mg/day (n=14) vs. 400 mg/day (n=8) of the DRT (1.55 μg/mL (1.08-2.5) vs. 2.5 μg/mL (1.85-2.7), p=0.19).
Conclusion: The DRT leads to more consistent levels in the therapeutic range compared to the OS. Standard dosing of 300 mg/day of the DRT achieves adequate concentrations for prophylaxis and treatment.
C. Weber, None
C. Siebenaller, None
E. Cober, None
E. Neuner, None