Pharmacy, Health Sciences & Exercise Science

Evaluation of Posaconazole Use Within the IU Health System

Presenter Information

Eric Harmon, Butler University

Document Type

Oral Presentation

Location

Indianapolis, IN

Subject Area

Pharmacy, Health Sciences & Exercise Science

Start Date

10-4-2015 11:30 AM

End Date

10-4-2015 12:00 PM

Description

Background: Posaconazole is a broad spectrum antifungal approved for prophylaxis of invasive fungal infections caused by Candida and Aspergillosis species in immunocompromised patients and for treatment of oropharyngeal candidiasis. Case reports suggest utility in rarer fungal infections. Posaconazole has been in use within the IU Health System since 2006 with few restrictions at most sites. As there has been no retrospective review of posaconazole use at IU Health, and with the arrival of newer dosage forms and literature, interest was show in assessing whether or not posaconazole usage was in accordance with literature.

Methods: This was a retrospective chart review of inpatients within the IU Health System who received posaconazole during the twelve month period of June 2013 to June 2014. Patients' electronic medical records were reviewed to capture indication for use, dosage, frequency and number of doses received, duration of therapy, results of cultures if obtained, and use of concomitant antifungals. Descriptive statistics were used to determine the frequency of off-label and non-guidelines based use of posaconazole.

Results: Forty patients who had received posaconazole during the review period were included, encompassing 78 encounters. Of those encounters, 52 were in accordance with recommendations in literature. Fifty-three encounters saw posaconazole used for prophylaxis of fungal infection, nine for Aspergillosis infection of any type, one for oral infection, eight for other infections where the suspected organism was not stated, and seven for an unknown indication.

Conclusion: The use of posaconazole within the IU Health System is largely in accordance with literature recommendations. However, there is enough off-label use and unsubstantiated dosing to warrant consideration of stricter dosing protocols.

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Apr 10th, 11:30 AM Apr 10th, 12:00 PM

Evaluation of Posaconazole Use Within the IU Health System

Indianapolis, IN

Background: Posaconazole is a broad spectrum antifungal approved for prophylaxis of invasive fungal infections caused by Candida and Aspergillosis species in immunocompromised patients and for treatment of oropharyngeal candidiasis. Case reports suggest utility in rarer fungal infections. Posaconazole has been in use within the IU Health System since 2006 with few restrictions at most sites. As there has been no retrospective review of posaconazole use at IU Health, and with the arrival of newer dosage forms and literature, interest was show in assessing whether or not posaconazole usage was in accordance with literature.

Methods: This was a retrospective chart review of inpatients within the IU Health System who received posaconazole during the twelve month period of June 2013 to June 2014. Patients' electronic medical records were reviewed to capture indication for use, dosage, frequency and number of doses received, duration of therapy, results of cultures if obtained, and use of concomitant antifungals. Descriptive statistics were used to determine the frequency of off-label and non-guidelines based use of posaconazole.

Results: Forty patients who had received posaconazole during the review period were included, encompassing 78 encounters. Of those encounters, 52 were in accordance with recommendations in literature. Fifty-three encounters saw posaconazole used for prophylaxis of fungal infection, nine for Aspergillosis infection of any type, one for oral infection, eight for other infections where the suspected organism was not stated, and seven for an unknown indication.

Conclusion: The use of posaconazole within the IU Health System is largely in accordance with literature recommendations. However, there is enough off-label use and unsubstantiated dosing to warrant consideration of stricter dosing protocols.