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Posaconazole

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https://www.readbyqxmd.com/read/27917735/top-1-of-inpatients-administered-antimicrobial-agents-comprising-50-of-expenditures-a-descriptive-study-and-opportunities-for-stewardship-intervention
#1
Jennifer Dela-Pena, Luiza Kerstenetzky, Lucas Schulz, Ron Kendall, Alexander Lepak, Barry Fox
OBJECTIVE To characterize the top 1% of inpatients who contributed to the 6-month antimicrobial budget in a tertiary, academic medical center and identify cost-effective intervention opportunities targeting high-cost antimicrobial utilization. DESIGN Retrospective cohort study. PATIENTS Top 1% of the antimicrobial budget from July 1 through December 31, 2014. METHODS Patients were identified through a pharmacy billing database. Baseline characteristics were collected through a retrospective medical chart review...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27915304/invasive-aspergillosis-in-acute-myeloid-leukemia-are-we-making-progress-in-reducing-mortality
#2
Giulia Dragonetti, Marianna Criscuolo, Luana Fianchi, Livio Pagano
The incidence of invasive fungal disease (IFD) has varied during the last decades. However, over the years, we have observed a progressive reduction of mortality, mainly due to wider use of prophylactic antifungal therapy (i.e., new azoles, such as posaconazole), the development of new and more effective antifungal drugs (lipid compounds of amphotericin B, candins, and azoles of the previous generation) and improvement of diagnostic tools. Based on a number of international studies across three decades, the attributable mortality rate for IFD and invasive aspergillosis (IA) among patients with acute myeloid leukemia (AML) has progressively declined...
December 2, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27915302/givinostat-exhibits-in-vitro-synergy-with-posaconazole-against-aspergillus-spp
#3
Yi Sun, Lujuan Gao, Chengyan He, Qingzhi Wu, Ming Li, Tongxiang Zeng
In vitro interactions of givinostat, a hydroxamate-derived histone deacetylase inhibitor, and antifungals including itraconazole, voriconazole, posaconazole, amphotericin B and caspofungin against Aspergillus spp. were assessed via broth microdilution checkerboard technique system. A total of 30 isolates of Aspergillus spp., including 20 strains of A. fumigatus and 10 strains of A. flavus were studied. The results revealed favorable synergistic effects between givinostat and posaconazole (83.3%) against Aspergillus isolates...
December 2, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27910211/comparison-of-serum-concentrations-between-different-dosing-strategies-of-posaconazole-delayed-release-tablet-at-a-large-academic-medical-centre
#4
Sarah Welch, Andrea Pallotta, Catherine Weber, Caitlin Siebenaller, Eric Cober, Elizabeth Neuner
It is unclear if the prophylaxis dose of 300 mg/day is sufficient for achieving serum concentrations targeting the treatment of invasive fungal infections. To evaluate differences between PCZ serum concentrations in patients receiving the DRT vs the OS and in patients receiving higher doses than 300 mg/day of the DRT, a retrospective review was conducted on inpatients who received PCZ for either treatment or prophylaxis. Baseline demographics including comorbid conditions, indication and dose of therapy were collected...
December 1, 2016: Mycoses
https://www.readbyqxmd.com/read/27910191/tintelnotia-a-new-genus-in-phaeosphaeriaceae-harbouring-agents-of-cornea-and-nail-infections-in-humans
#5
S A Ahmed, W Hofmüller, M Seibold, G S de Hoog, H Harak, I Tammer, A D van Diepeningen, W Behrens-Baumann
Phaeosphaeriaceae is a family in the order Pleosporales containing numerous plant pathogens, endophytes, lichenised fungi, and environmental saprobes. A novel genus, Tintelnotia is introduced containing two species, one of which caused an eye infection and several nail infections in humans. All species of Tintelnotia produce conidia in soft pycnidia with a wide ostiole. The generic type species is T. opuntiae causing necrotic spots on cactus plants. The isolates of the human opportunist T. destructans showed variable susceptibility pattern to a panel of common antifungal agents...
December 1, 2016: Mycoses
https://www.readbyqxmd.com/read/27906977/development-of-a-pcr-assay-to-detect-low-level-trypanosoma-cruzi-in-blood-specimens-collected-with-paxgene-blood-dna-tubes-for-clinical-trials-treating-chagas-disease
#6
Bo Wei, Lei Chen, Miho Kibukawa, John Kang, Hetty Waskin, Matthew Marton
Chagas disease is caused by the parasitic infection of Trypanosoma cruzi (T. cruzi). The STOP CHAGAS clinical trial was initiated in 2011 to evaluate posaconazole in treating Chagas disease, with treatment success defined as negative qualitative PCR results of detecting the parasites in blood specimens collected post-treatment. PAXgene Blood DNA tubes were utilized as a simple procedure to collect and process blood specimens. However, the PAXgene blood specimens challenged published T. cruzi PCR methods, resulting in poor sensitivity and reproducibility...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27905900/prevalence-clinical-and-economic-burden-of-mucormycosis-related-hospitalizations-in-the-united-states-a-retrospective-study
#7
Dimitrios P Kontoyiannis, Hongbo Yang, Jinlin Song, Sneha S Kelkar, Xi Yang, Nkechi Azie, Rachel Harrington, Alan Fan, Edward Lee, James R Spalding
BACKGROUND: Mucormycosis is a rare but devastating fungal infection primarily affecting immunocompromised patients such as those with hematological malignancy, bone marrow and solid organ transplantation, and patients with diabetes, and, even more rarely, immunocompetent patients. The objective of this study was to assess the prevalence and burden, both clinical and economic, of mucormycosis among hospitalized patients in the U.S. METHODS: This is a retrospective study using the Premier Perspective(TM) Comparative Database, with more than 560 participating hospitals covering 104 million patients (January 2005-June 2014)...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27904738/recent-developments-in-the-management-of-invasive-fungal-infections-in-patients-with-oncohematological-diseases
#8
REVIEW
Markus Ruhnke, Stefan Schwartz
Patients with hematological cancer have a high risk of invasive fungal diseases (IFDs). These infections are mostly life threatening and an early diagnosis and initiation of appropriate antifungal therapy are essential for the clinical outcome. Most commonly, Aspergillus and Candida species are involved. However, other non-Aspergillus molds are increasingly be identified in cases of documented IFDs. Important risk factors are long lasting granulocytopenia with neutrophil counts below 500/μl for more than 10 days or graft-versus-host disease resulting from allogeneic stem-cell transplantation...
December 2016: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/27900242/management-of-rhinomaxillary-mucormycosis-with-posaconazole-in-immunocompetent-patients
#9
Sachin Rai, Shikha Yadav, Dinesh Kumar, Vijay Kumar, Vidya Rattan
Mucormycosis is an opportunistic, uncommon and serious systemic fungal infection mostly presenting in immunocompromised patients. The combination of surgical debridement, parenteral therapy with Amphotericin B and management of the underlying systemic disease is the standard treatment modality for mucormycosis. The drawback of this regime is the need for long hospitalization due to the serious side effects of Amphotericin B requiring regular monitoring. Oral Posaconazole is one of the newer antifungals that have shown promising results...
November 2016: Journal of Oral Biology and Craniofacial Research
https://www.readbyqxmd.com/read/27890675/synergistic-drug-combination-effectively-blocks-ebola-virus-infection
#10
Wei Sun, Shihua He, Carles Martínez-Romero, Jennifer Kouznetsova, Gregory Tawa, Miao Xu, Paul Shinn, Ethan Fisher, Yan Long, Omid Motabar, Shu Yang, Philip E Sanderson, Peter R Williamson, Adolfo García-Sastre, Xiangguo Qiu, Wei Zheng
Although a group of FDA-approved drugs were previously identified with activity against Ebola virus, most of them are not clinically useful because their human blood concentrations are not high enough to inhibit EBOV infection. We screened 795 unique three-drug combinations in an EBOV entry assay. Two sets of three-drug combinations, toremifene-mefloquine-posaconazole and toremifene-clarithromycin-posaconazole, were identified that effectively blocked EBOV entry and were further validated for inhibition of live EBOV infection...
November 24, 2016: Antiviral Research
https://www.readbyqxmd.com/read/27889253/blood-and-tissue-distribution-of-posaconazole-in-a-rat-model-of-invasive-pulmonary-aspergillosis
#11
E Cendejas-Bueno, A Forastiero, I Ruiz, E Mellado, J Gavaldà, A Gomez-Lopez
Posaconazole is the recommended prophylactic agent in patients at high risk of invasive fungal infection, since adequate drug levels seem to be reached in target sites despite the relatively low levels detected in blood. The objective of this study is to obtain pharmacokinetic (PK) information associated to blood and tissue distribution of posaconazole in an animal model of invasive pulmonary aspergillosis. The PK parameters in lung samples were systematically higher than in serum. After multiple-dose administration of posaconazole, a significant accumulation of the drug was evident in lung tissue...
October 11, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27866319/successful-posaconazole-therapy-of-disseminated-alternariosis-due-to-alternaria-infectoria-in-a-heart-transplant-recipient
#12
Pavlina Lyskova, Milos Kubanek, Vit Hubka, Eva Sticova, Ludek Voska, Dana Kautznerova, Miroslav Kolarik, Petr Hamal, Martina Vasakova
We report a case of phaeohyphomycosis caused by Alternaria infectoria in a 61-year-old heart transplant recipient with multiple skin lesions and pulmonary infiltrates. The infection spread via the haematogenous route from the primary cutaneous lesions into the lungs. The diagnosis was based on the histopathological examination, direct microscopy, skin lesion cultures and detection of Alternaria DNA in the bronchoalveolar lavage fluid using molecular methods. The treatment consisted of a combination of surgical excision and systemic antifungal therapy...
November 19, 2016: Mycopathologia
https://www.readbyqxmd.com/read/27866173/a-rapid-uplc-ms-ms-assay-for-the-simultaneous-measurement-of-fluconazole-voriconazole-posaconazole-itraconazole-and-hydroxyitraconazole-concentrations-in-serum
#13
Sankha S Basu, Athena Petrides, Donald S Mason, Petr Jarolim
BACKGROUND: Triazole antifungals are essential to the treatment and prophylaxis of fungal infections. Significant pharmacokinetic variability combined with a clinical need for faster turnaround times has increased demand for in-house therapeutic drug monitoring of these drugs, which is best performed using mass spectrometry-based platforms. However, technical and logistical obstacles to implementing these platforms in hospital laboratories have limited their widespread utilization. Here, we present the development and validation of a fast and simple ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to measure fluconazole, voriconazole, posaconazole, itraconazole, and hydroxyitraconazole in human serum suitable for incorporation into a hospital clinical laboratory...
November 21, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27865610/assessment-of-bioequivalence-of-weak-base-formulations-under-various-dosing-conditions-using-physiologically-based-pharmacokinetic-simulations-in-virtual-populations-case-examples-ketoconazole-and-posaconazole
#14
Rodrigo Cristofoletti, Nikunjkumar Patel, Jennifer B Dressman
Postabsorptive factors which can affect systemic drug exposure are assumed to be dependent on the active pharmaceutical ingredient (API), and thus independent of formulation. In contrast, preabsorptive factors, for example, hypochlorhydria, might affect systemic exposure in both an API and a formulation-dependent way. The aim of this study was to evaluate whether the oral absorption of 2 poorly soluble, weakly basic APIs, ketoconazole (KETO) and posaconazole (POSA), would be equally sensitive to changes in dissolution rate under the following dosing conditions-coadministration with water, with food, with carbonated drinks, and in drug-induced hypochlorhydria...
November 16, 2016: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27862750/skin-lesion-in-a-patient-with-acute-myeloid-leukemia
#15
Atul Kothari, Sara C Shalin, Juan Carlos Crescencio, Mary J Burgess
We present the case of a 51-year-old man with acute myeloid leukemia who developed fevers with a skin lesion following the first cycle of induction chemotherapy. Skin biopsy showed evidence of invasive fungal infection. Cultures remained negative, but polymerase chain reaction on tissue detected Rhizopus oryzae complex. Patient was started on liposomal amphotericin B and underwent surgical debridement. He was switched to posaconazole, with plans for allogeneic hematopoetic stem cell transplant in the future...
November 16, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27856723/acute-reversible-pancreatitis-induced-by-posaconazole
#16
Benoit Pilmis, Helene Coignard-Biehler, Claire Rouzaud, Vincent Jullien, Fanny Lanternier, Olivier Lortholary
No abstract text is available yet for this article.
November 17, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27856196/a-fabric-phase-sorptive-extraction-high-performance-liquid-chromatography-photo-diode-array-detection-method-for-the-determination-of-twelve-azole-antimicrobial-drug-residues-in-human-plasma-and-urine
#17
Marcello Locatelli, Abuzar Kabir, Denise Innosa, Teresa Lopatriello, Kenneth G Furton
This paper reports a novel fabric phase sorptive extraction-high performance liquid chromatography-photodiode array detection (FPSE-HPLC-PDA) method for the simultaneous extraction and analysis of twelve azole antimicrobial drug residues that include ketoconazole, terconazole, voriconazole, bifonazole, clotrimazole, tioconazole, econazole, butoconazole, miconazole, posaconazole, ravuconazole, and itraconazole in human plasma and urine samples. The selected azole antimicrobial drugs were well resolved by using a Luna C18 column (250mm×4...
November 11, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27855164/trypanosoma-brucei-cyp51-essentiality-and-targeting-therapy-in-an-experimental-model
#18
Frédéric-Antoine Dauchy, Mélanie Bonhivers, Nicolas Landrein, Denis Dacheux, Pierrette Courtois, Florian Lauruol, Sylvie Daulouède, Philippe Vincendeau, Derrick R Robinson
Trypanosoma brucei gambiense is the main causative agent of Human African Trypanosomiasis (HAT), also known as sleeping sickness. Because of limited alternatives and treatment toxicities, new therapeutic options are urgently needed for patients with HAT. Sterol 14alpha-demethylase (CYP51) is a potential drug target but its essentiality has not been determined in T. brucei. We used a tetracycline-inducible RNAi system to assess the essentiality of CYP51 in T. brucei bloodstream form (BSF) cells and we evaluated the effect of posaconazole, a well-tolerated triazole drug, within a panel of virulent strains in vitro and in a murine model...
November 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27851484/1849-posaconazole-digoxin-drug-drug-interaction-mediated-by-inhibition-of-p-glycoprotein
#19
Abby Dunker, Heather Bullard, Jane Churpek, Randall Knoebel
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27830376/clinical-effectiveness-of-itraconazole-as-antifungal-prophylaxis-in-aml-patients-undergoing-intensive-chemotherapy-in-the-modern-era
#20
C L Keighley, P Manii, S R Larsen, S van Hal
Antifungal prophylaxis regimens vary between centres, informed by local epidemiology and antifungal stewardship practices. The advantages of itraconazole over posaconazole prophylaxis include maintaining the utility of azole therapy for suspected breakthrough invasive fungal infection (bIFI). We examined the effectiveness and tolerability of itraconazole as prophylaxis in acute myeloid leukaemia (AML) patients. We sought to determine the rate of probable and proven bIFI in the context of itraconazole prophylaxis in a real-life setting...
November 9, 2016: European Journal of Clinical Microbiology & Infectious Diseases
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