Pharmacokinetics of posaconazol in the prophylaxis and treatment of invasive fungal infection in immunocompromised children in a pediatric hospital

Background: There is no consensus on the optimal dosage use of posaconazole (PSC) for invasive fungal infection (IFI) in pediatric patients and normally it is adjusted with drug levels (DLs) >= 0.7 mu g/ml and >= 1.25 mu g/ml for prophylaxis and treatment, respectively. Objective: To describe the experience of monitoring DLs of PSC in immunocompromised pediatric patients with IFI and to determine if the recommended doses reach CP effective in prophylaxis (>= 0.7 mu g/mL) and treatment (>= 1.25 mu g/mL). Method: A retrospective analysis in children who received PSC from January 2012 to October 2016, in the Oncology and Bone Marrow Transplant units at Hospital Calvo Mackenna was done. Results: Six patients with 78 DLs were reviewed (4 prophylaxis and 4 treatment). Median PSC dose was 12.5 and 18.8 mg/kg/d for prophylaxis and treatment, resulting in mean DLs of 0.97 and 1.8 mu g/mL respectively. In prophylaxis 40/67 (60%) were recorded with DLs >= 0.70 mu g/mL receiving a median dose of 12.5 mg/kg/d. While for treatment: 5/11 (46%) presented DLs >= 1.25 mu g/mL, receiving a median dose of 18 mg/kg/d. Conclusion: Our results are in line with the recommended for PSC dosage, but individualized monitoring is required to maintain adequate DLs.