Making sense of posaconazole therapeutic drug monitoring: A practical approach

Abstract

PURPOSE OF REVIEW: Therapeutic drug monitoring (TDM) may be an important adjunct to optimizing the use of posaconazole. RECENT FINDINGS: Limited clinical studies suggest that an exposure-response relationship for posaconazole exists for the treatment of established invasive fungal diseases (IFDs), with emerging but less compelling data supporting its role in prophylaxis. The high prevalence of subtherapeutic levels has not translated to high prophylactic failure rates perhaps because of preferential uptake by effector cells important in the front-line defence against Aspergillus species. Nevertheless, TDM would appear prudent in patients deemed at highest risk for IFD with correction of pati..