Abstract | PURPOSE: PATIENTS AND METHODS: We retrospectively reviewed the records of patients treated for AML treated with PSZ, during a 2-year period. Assays<500ng/mL were considered as under dosed. RESULTS: Fifty-nine assays (43 patients) were performed during induction (n=22) or consolidation (n=37) chemotherapy. PSZ treatment was initiated within a median of 3 days before neutropenia with a first assay performed at 8 days (3-28). The median PSZ blood plasma concentration was 375ng/mL (<200-1900). Forty-one (69%) treatment were maintained until the end of neutropenia. One patient presented with candidemia, 9 with possible invasive aspergillosis, without any significant association with underdosing. The univariate analysis showed that co-administration of proton pump inhibitors (PPIs) (P=0.01) and cause of hospitalization ( induction chemotherapy vs consolidation, P=0.008) were associated with underdosing, contrary to feeding difficulties (P=0.07) and digestive disorders (P=0.5). The multivariate analysis confirmed the impact of PPI use (P=0.01) and the cause of hospitalization (P=0.003). CONCLUSION: This study highlights the major impact of PPI administration on PSZ blood plasma levels and stresses the risk of non-effective prophylaxis during induction treatment of AML.
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Authors | P-Y Desplanques, R Burlacu, V Poinsignon, H Boussion, I Borget, B Wyplosz, S de Botton, E Billaud, E Chachaty, B Gachot, F Netzer, J-B Micol |
Journal | Medecine et maladies infectieuses
(Med Mal Infect)
Vol. 44
Issue 4
Pg. 174-9
(Apr 2014)
ISSN: 1769-6690 [Electronic] France |
PMID | 24656841
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 Elsevier Masson SAS. All rights reserved. |
Chemical References |
- Antifungal Agents
- Triazoles
- posaconazole
|
Topics |
- Adult
- Aged
- Antifungal Agents
(administration & dosage, blood)
- Aspergillosis
(etiology, prevention & control)
- Drug Monitoring
- Female
- Humans
- Leukemia, Myeloid, Acute
(blood, complications, drug therapy)
- Male
- Middle Aged
- Retrospective Studies
- Triazoles
(administration & dosage, blood)
- Young Adult
|