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Abstract

Background and Objectives: Posaconazole (PSZ), is an antifungal prophylactic therapy that is used in hematologic cancer patients. It is approved for prophylaxis in hematologic cancer patients ≥13 years in USA, Canada, Australia, and ≥18 years in the European Union. In 2010, PSZ was added to the formulary of Al-Amal Hospital, the only adult cancer hospital in Qatar. The objective of this study is to conduct a drug use evaluation (DUE) study of posaconazole at Al-Amal Hospital. Methods: A retrospective, single centered, observational DUE study was conducted to include a convenient sample of hematologic cancer patients who used PSZ prophylactically during the year 2010. All patients, thirty-one, who received PSZ in 2010 were nominated of which 20 patients' profiles were reviewed, data were collected into a pre-prepared collection sheet and descriptive analysis was performed. Results: In Qatar, PSZ was used prophylactically in hematologic cancer patients >15 years with febrile and afebrile neutropenia. It is also planned to be used prophylactically for the upcoming bone marrow transplantation unit patients. All the 20 patients, 17 males and 3 females, received the PSZ for prophylaxis and were compliant. More than 50% of patients received proton pump inhibitors concurrently with posaconazole. Only 1 case had a recorded recommendation regarding the administration of PSZ with food. Five patients received vincristine-based chemotherapy protocol, one of which received it concurrently with PSZ for two cycles and developed seizure. Two patients developed mild breakthrough fungal infection, oral thrush, while on PSZ prophylactically. Conclusion: The PSZ regulations in Qatar are similar to the worldwide recommendations. The PSZ practice in Al-Amal hospital abides by the regulations. However, three points need to be addressed: PSZ has low bioavailability that can be enhanced by taking it with meals and by dividing the total daily dose. PSZ co-administration with proton pump inhibitors should be stopped as it may result in PSZ sub-therapeutic levels. Possible serious PSZ drug-drug interactions, seizures, in adult hematologic cancer patients should be highlighted and carefully monitored.

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/content/papers/10.5339/qfarf.2012.BMP41
2012-10-01
2020-06-02
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http://instance.metastore.ingenta.com/content/papers/10.5339/qfarf.2012.BMP41
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