Use of posaconazole in the treatment of invasive fungal infections

Abstract

The emergence of invasive fungal infections as an increasingly important clinical problem in immunocompromised patients highlights the need for more effective antifungal agents and better strategies for prevention, diagnosis and treatment. Posaconazole is an extended-spectrum triazole with broad activity against a variety of fungal pathogens, both yeasts and molds. In particular, it has activity against several emerging pathogens, such as the Zygomycetes, which are resistant to many currently available antifungals, making it an attractive agent for use in both prophylactic and therapeutic situations. Studies demonstrating the prophylactic utility of posaconazole in neutropenic patients with acute myelogenous leukemia or myelodysplastic syndrome, and in patients with graft-versus-host disease following allogeneic stem cell transplantation has led to the approval of the drug in the USA. These data have been reviewed elsewhere in detail. Published data on posaconazole as primary antifungal therapy are very limited, although there is a considerable amount of experience with the drug in the salvage setting following failure of or intolerance to other antifungal agents. In this review we will focus on the use of posaconazole for treatment of established invasive fungal infections, with a focus on opportunistic infections in immunocompromised patients.

Keywords::

• antifungal
• aspergillus
• azole
• Candida
• Fusarium
• mold
• mucormycosis
• posaconazole
• yeast
• zygomycetes

Financial & competing interests disclosure

Amelia A Langston is an investigator on antifungal clinical trials sponsored by Schering Plough, Pfizer, and the Mycoses Study Group. She has also served as a consultant on advisory boards for Schering Plough Research Institute. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.