ArticleMycoses2020
High-dose posaconazole for azole-resistant aspergillosis and other difficult-to-treat mould infections.
Article in Mycoses, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Guideline
- Posaconazole for prevention of invasive pulmonary aspergillosis in critically ill influenza patients (POSA-FLU): a randomised, open-label, proof-of-concept trial.Intensive care medicine · 2021Trial
- Genotype-Phenotype Relationships in Azole-ResistantJournal of fungi (Basel, Switzerland) · 2026Review
- Risk Factors for Subtherapeutic Exposure and Hepatotoxicity Threshold of Posaconazole: A Real-World Study in Chinese Patients with Invasive Pulmonary Fungal Infection.Infection and drug resistance · 2026Article
- Efficacy of voriconazole combined with caspofungin in treating Chronic Obstructive Pulmonary Disease patients with invasive pulmonary aspergillosis: impacts on clinical outcomes, inflammatory cytokines, and immune markers.Frontiers in immunology · 2026Article
- Bronchoscopic local instillation of amphotericin B deoxycholate as adjunctive therapy for pulmonary mucormycosis with inadequate response to posaconazole: a retrospective case series.Frontiers in medicine · 2026Article
- Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- Successful Treatment of Mucormycosis and Azole-ResistantInfection and drug resistance · 2025Article
- EmergingJAC-antimicrobial resistance · 2024Article
- Personalized Antifungal Therapy Through Model-Informed Precision Dosing of Posaconazole.Clinical pharmacokinetics · 2024Article
- Invasive Aspergillosis of Nose and Paranasal Sinus in COVID-19 Convalescents: Mold Goes Viral?Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2022Article
- Isavuconazole in the Treatment ofAntibiotics (Basel, Switzerland) · 2022Review
- Profiling of Antifungal Activities and In Silico Studies of Natural Polyphenols from Some Plants.Molecules (Basel, Switzerland) · 2021Article
- Effect of High-Dose Posaconazole on Serum Levels in Adult Patients with Hematologic Malignancy.Antimicrobial agents and chemotherapy · 2021Article
- Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance.The Lancet. Infectious diseases · 2021Review
- Role and Interpretation of Antifungal Susceptibility Testing for the Management of Invasive Fungal Infections.Journal of fungi (Basel, Switzerland) · 2020Review
- Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium.Antibiotics (Basel, Switzerland) · 2020Review
- Azole-resistant Aspergillus and Echinocandin-resistant Candida - What are the treatment options?Current fungal infection reports · 2020Article
- High-dose posaconazole for azole-resistant aspergillosis and other difficult-to-treat mould infections.Mycoses · 2020Article
- Invasive pulmonary aspergillosis in the post-COVID-19 era: diagnosis, treatment, and what lies ahead.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOral follow-up therapy is problematic in moulds with reduced azole-susceptibility, such as azole-resistant Aspergillus fumigatus infection. Currently, only intravenous liposomal amphotericin B (L-AmB) is advocated by guidelines for the treatment of azole-resistant aspergillosis infections. Preclinical research indicates that high-dose posaconazole (HD-POS) might be a feasible option provided that high drug exposure (ie POS serum through levels >3 mg/L) can be achieved and is safe.
objectivesTo describe our experience with the use of oral HD-POS as treatment strategies for patients infected with pathogens with a POS MIC close to the clinical breakpoint. PATIENTS/
methodsWe review evidence supporting the use of HD-POS and describe our experience on safety and efficacy in 16 patients. In addition, we describe the adverse events (AE) observed in 25 patients with POS concentrations at the higher end of the population distribution during treatment with the licensed dose.
resultsSixteen patients were treated intentionally with HD-POS for voriconazole-resistant invasive aspergillosis (7/16), mucormycosis (4/16), salvage therapy for IA (4/16) and IA at a sanctuary site (spondylodiscitis) in 1. Grade 3-4 AEs were observed in 6, and all of them were considered at least possibly related. Grade 3-4 AEs were observed in 5 of the 25 patients with spontaneous high POS serum through levels considered at least possibly related using Naranjo scale.
conclusionsHigh-dose posaconazole is a treatment option if strict monitoring for both exposure and for AE is possible.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.