Impact of testing posaconazole plasma concentrations on epidemiology of antifungal prophylaxis and therapy in patients with haematologic malignancies: case-control study

Ref ID: 17765

Author:

M. Hoenigl*, K. Seeber, R. Raggam, T. Valentin, A. Valentin,
A. Strohmeier, I. Zollner-Schwetz, A. Woelfler, A. Grisold, W. Linkesch,
R. Krause

Author address:

(Graz, AT)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objective: Therapeutic drug monitoring (TDM) has shown useful for
oral antifungal agents in patients with hematologic malignancies. The
effect of introduction of TDM on prescribing praxis is unknown. We
evaluated the impact of posaconazole TDM on antifungal prophylaxis
and therapy.
Methods: Applied antifungal prophylaxis and therapy were assessed in
patients with underlying hematologic diseases by conducting a
prospective observational single-centre study at the Division of
Hematology, Medical University of Graz, Austria, for 7 months in
2010. To analyze the impact of PPC testing on antifungal prophylaxis
and therapy results obtained were compared to a representative
collective of patients assessed by the same investigators at the same
institution over 7 months in 2007 before testing of posaconazole plasma
concentrations (PPCs) has been introduced.
Results: In 2010, 129/729 (18%) of cases with hematologic
malignancies received systemic antifungal prophylaxis and therapy.
Of those, fifty-seven percent received prophylactic, 44% empiric, 30%
preemptive and 6% directed antifungal therapy. Main reasons for
prophylaxis were neutropenia in AML patients (40/74; 54%), followed
by GVHD (18/74; 24%) and allogeneic HSCT (16/74; 22%). Eleven
out of 39 (28%) cases receiving preemptive therapy had clinical/
radiological and microbiological evidence of IFI, 26/39 (67%) had
clinical/radiological and 2/39 (5%) only microbiological evidence of

Abstract Number: P857

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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