Abstract
Posaconazole is the newest antifungal agent to be approved for use in Canada. With excellent in vitro activity against a broad spectrum of yeasts and filamentous fungi, as well as having a well-tolerated oral formulation, posaconazole offers many potential advantages. Of particular interest are its seemingly lower potential for cross-resistance with other azoles and its activity (unique among oral antifungal agents) against the zygomycetes. As the incidence of both common and uncommon fungal infections increases commensurate with the growing population of immunocompromised individuals, posaconazole may ultimately become an important therapeutic option. The present article reviews the in vitro and in vivo data describing its activity, and focuses on both the proven and the potential clinical applications of this new triazole agent.
Highlights
Posaconazole is the newest antifungal agent to be approved for use in Canada
While the present study suggests that posaconazole is effective as chronic suppressive therapy for refractory mucosal candidiasis in the select subpopulation of patients who can tolerate long-term treatment, almost one-third of the modified intention-to-treat population discontinued therapy within three months, and almost 50% of these patients had a clinical relapse within one month of treatment discontinuation
Posaconazole, has a very specific indication for the treatment of invasive aspergillosis that is refractory to amphotericin B or itraconazole, or that occurs in patients intolerant of these agents
Summary
Posaconazole is the newest antifungal agent to be approved for use in Canada. With excellent in vitro activity against a broad spectrum of yeasts and filamentous fungi, as well as having a well-tolerated oral formulation, posaconazole offers many potential advantages. In the present study of posaconazole salvage therapy, the infecting species of Candida was resistant to fluconazole and/or itraconazole in the majority of patients.
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