Posaconazole Salvage Treatment in Pediatric Patients: A Multicenter Survey

A.H. Groll1, A. Attarbaschi2, M. Duerken2, J. Garbino2, U. Kontny2, S. Luer2, R. Phillips2, J. Scholz2, T. Wiesel2, H.J. Wagner2, B. Gruhn2, T. Lehrnbecher2

Author address: 

1Children's University Hospital, MíœNSTER, Germany 2Children's Hospital, VIENNA, Austria

Abstract: 

Background: While a pediatric dosage has not been defined, posaconazole is occasionally used in pediatric patients. We conducted a multicenter retrospective survey to obtain data on pediatric patients considered to require posaconazole salvage therapy. Methods: The survey identified 15 pts. (median age: 10 years; range, 3.6-17.5; 9 f, 6 m) with hematologic malignancies (10), marrow failure (1), solid tumor (1), soft tissue trauma (1), CGD (1), and diabetes mellitus (1) who received posaconazole for proven (9) or probable (6) invasive fungal infections (zygomycosis (7), mold infection (4), aspergillosis (2), chronic disseminated candidiasis (2)). Posaconazole was administered until intolerance or maximum efficacy at dosages individually determined by the responsible physician for refractory infection (8), intolerance of other agents (1) or as best therapeutic option (6) following pretreatment for a median of 22 days (r, 4-319). Results: The 15 patients received posaconazole for a median of 32 days (r, 4 to 262) as single agent (6) or in combination (9). The median daily dosage was 21 mg/kg (r, 4.8-33.3). In none of patients was therapy discontinued due to adverse events. Clinical adverse events were mostly mild to moderate and observed in 11 patients (73%). Relevant increases in laboratory parameters to x3 the baseline value at end of treatment were limited to serum bilirubin (3 pts.) and SGOT (1 pt). Complete or partial responses were observed 4/7 pts. with zygomycosis, 3/4 pts. with invasive mold infections, 1/2 pts. with invasive aspergillosis and 1/2 pts. with CDC. Altogether, 6 patients had a complete and 3 patients a partial response, accounting for an overall response rate of 60%. Overall survival at three months post start of treatment was 73% (11/15). Conclusion: Posaconazole displayed favorable safety and tolerance and was useful for management of individual pediatric patients with invasive infections.
2009

abstract No: 

P325

Full conference title: 

4th Trends in Medical Mycology
    • TIMM 4th (2012)