Posaconazole oral dose and plasma levels in pediatric hematology-oncology patients.

BackgroundPosaconazole is a triazole with limited pharmacokinetic information in children. This study assessed the correlation between posaconazole oral solution daily dosage/kg/body weight and trough plasma level. MethodsA total of 97 hematology-oncology pediatric patients with 1 posaconazole plasma concentration level (PPC) assessment in the first 6weeks after the start of posaconazole treatment were included. ResultsPosaconazole was used as prophylaxis in 84 of 97 (87%) patients and as therapy in 13 of 97 (13%). The median daily dose/kg/bw ranged from 10 to 12mg in the prophylaxis group and 12.5 to 16.5mg in the therapy group. The median value of PPC for the prophylaxis group was 0.9 and 0.8g/mL at the first and second/third determinations, respectively. Posaconazole prophylaxis failed in 4 of 84 patients (5%). The median value of PPC for the therapy group was 1.5 and 1.4g/mL at the first/second and the third determination, respectively. Posaconazole-related side effects were reported in 6 patients and all regressed with the suspension of the drug. In the prophylaxis group, the use of proton-pump inhibitors was significantly associated with a lower PPC, P = 0.04. ConclusionsPosaconazole may be a valuable antifungal agent in children despite the incomplete knowledge of its pharmacokinetic characteristics.