TY - JOUR
T1 - Supratherapeutic posaconazole concentration in a pediatric transplant patient with confirmed rhizopus infection
AU - Vu, Christine A.
AU - Riollano-Cruz, Mariawy
AU - Kowalsky, Shanna R.
N1 - Publisher Copyright:
© Pediatric Pharmacy Association. All rights reserved.
PY - 2021
Y1 - 2021
N2 - There are a limited number of studies that guide dosing of posaconazole delayed-release (DR) tablets for the pediatric population. Current FDA-approved doses are only recommended for patients 13 years and older. For younger patients, providers are faced with the challenge of recommending posaconazole doses extrapolated from adult studies or choosing an alternative agent. We report on a case of a 10-year-old patient who experienced a supratherapeutic trough serum concentration and transaminitis after receiving the extrapolated adult dosage of posaconazole DR tablets (300 mg twice daily for the first day, followed by 300 mg daily) for 7 days. In the end, the patient required a smaller dose of 200 mg daily to achieve the desired trough target concentration for the treatment of a Rhizopus neck infection. Our findings highlight the need for additional studies to determine the optimal dosing of posaconazole DR tablets for children. ABBREVIATIONS ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; DR, delayed-release; FDA, US Food and Drug Administration.
AB - There are a limited number of studies that guide dosing of posaconazole delayed-release (DR) tablets for the pediatric population. Current FDA-approved doses are only recommended for patients 13 years and older. For younger patients, providers are faced with the challenge of recommending posaconazole doses extrapolated from adult studies or choosing an alternative agent. We report on a case of a 10-year-old patient who experienced a supratherapeutic trough serum concentration and transaminitis after receiving the extrapolated adult dosage of posaconazole DR tablets (300 mg twice daily for the first day, followed by 300 mg daily) for 7 days. In the end, the patient required a smaller dose of 200 mg daily to achieve the desired trough target concentration for the treatment of a Rhizopus neck infection. Our findings highlight the need for additional studies to determine the optimal dosing of posaconazole DR tablets for children. ABBREVIATIONS ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; DR, delayed-release; FDA, US Food and Drug Administration.
KW - Invasive fungal infections
KW - Posaconazole
KW - Rhizopus
KW - Supratherapeutic
UR - http://www.scopus.com/inward/record.url?scp=85116419184&partnerID=8YFLogxK
U2 - 10.5863/1551-6776-26.7.753
DO - 10.5863/1551-6776-26.7.753
M3 - Article
AN - SCOPUS:85116419184
SN - 1551-6776
VL - 26
SP - 753
EP - 757
JO - Journal of Pediatric Pharmacology and Therapeutics
JF - Journal of Pediatric Pharmacology and Therapeutics
IS - 7
ER -