Real-Life Use of Posaconazole in Clinical Practice for Onco-Hematological Children: A National Survey by AIEOP Infectious Diseases Working Group
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Posaconazole is an antifungal medication used to treat invasive fungal infections (IFI) in pediatric onco-hematological patients. Its approval for pediatric use was recent, and limitations still apply. Despite limited data, the safety and efficacy profile appear generally favorable in children. This study describes how posaconazole is used across centers affiliated with the Associazione Italiana Ematologia e Oncologia Pediatrica (AIEOP). METHODS: A national survey was conducted among physicians within the AIEOP network to evaluate current use of posaconazole in pediatric cancer patients, including those undergoing hematopoietic stem cell transplantation (HSCT). A 25-item web questionnaire was developed and distributed in June 2024. Data analysis involved descriptive statistics. RESULTS: Twenty-one of thirty-one centers (68%) responded, reporting availability of various posaconazole formulations: oral suspension (76%), delayed-release tablets (95%), and intravenous solution (14%). Posaconazole was primarily used for prophylaxis in patients with acute lymphoblastic leukemia (ALL, 38%), acute myeloid leukemia (AML, 38%), and aplastic anemia (19%). It was also used as secondary prophylaxis against previous possible or probable IFI or as salvage therapy for probable or confirmed aspergillosis or mucormycosis, often combined with other treatments. Drug plasma level monitoring was common but varied in scheduling across centers. Most centers (74%) discontinued posaconazole if adverse events suspected drug-drug interactions, such as with vincristine. CONCLUSIONS: Posaconazole is widely used in AIEOP centers, though application varies significantly. This variability emphasizes the need for prospective studies to better define indications, dosing, and monitoring protocols for pediatric use of this antifungal.
Source: Journal of Fungi
DOI: 10.3390/jof11110797
Authors: Lorenzo Chiusaroli, Manuela Spadea, Cecilia Liberati, Maria Grazia Petris, Antonio Grasso, Francesco Baccelli, Maria Vittoria Micheletti, Pietro Gasperini, Maria Rosaria D’Amico, Katia Perruccio, Angelica Barone, Daniela Onofrillo, Paola Muggeo, Maura Faraci, Simona Rinieri, Ilaria Liguoro, Antonella Colombini, Francesca Trevisan, Nagua Giurici, Gianluca Boscarol, Letizia Pomponia Brescia, Alessia Pancaldi, Francesca Compagno, Alessandra Biffi, Daniele Donà, Simone Cesaro
Institutions: University of Padua, Azienda Ospedale - Università Padova, Ospedale Regina Margherita, Azienda Ospedaliera Universitaria Pisana, Azienda Unità Sanitaria Locale Rimini, Santobono Children's Hospital, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Istituto Giannina Gaslini, University of Ferrara, Arcispedale Sant'Anna, University of Udine, Azienda Ospedaliera San Gerardo, Meyer Children's Hospital, IRCCS Materno Infantile Burlo Garofolo, Ospedale di Bolzano, University of Modena and Reggio Emilia, Policlinico San Matteo Fondazione, Azienda Ospedaliera Universitaria Integrata Verona
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W4416077048