Posaconazole treatment of refractory coccidioidomycosis in dogs.
coccidioides
fungal infection
refractory
therapeutic drug monitoring
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
01
10
2021
received:
25
06
2021
accepted:
01
10
2021
pubmed:
19
10
2021
medline:
24
12
2021
entrez:
18
10
2021
Statut:
ppublish
Résumé
The majority of dogs with coccidioidomycosis recover with administration of fluconazole or itraconazole, although some cases are refractory or the dogs do not tolerate administration of these medications. The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole. Eight dogs with refractory coccidioidomycosis. Retrospective case series. Medical records from Veterinary Specialty Center of Tucson were searched to identify dogs with refractory coccidioidomycosis that were treated with posaconazole. Clinical information and the results of monitoring trough serum posaconazole concentrations were retrieved. Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10 mg/kg per day of posaconazole. Six of 8 dogs recovered or developed clinical remission while administered posaconazole. Thirteen serum concentrations from 8 dogs tested were >1 μg/mL (range, 1.52 to >6 μg/mL) and the drug was well-tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis. Posaconazole should be considered as a treatment option for dogs with refractory coccidioidomycosis. Monitoring of indicators of liver function or injury along with therapeutic drug monitoring is recommended to tailor dosage in the event of hepatic toxicosis.
Sections du résumé
BACKGROUND
BACKGROUND
The majority of dogs with coccidioidomycosis recover with administration of fluconazole or itraconazole, although some cases are refractory or the dogs do not tolerate administration of these medications.
OBJECTIVES
OBJECTIVE
The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole.
ANIMALS
METHODS
Eight dogs with refractory coccidioidomycosis.
METHODS
METHODS
Retrospective case series. Medical records from Veterinary Specialty Center of Tucson were searched to identify dogs with refractory coccidioidomycosis that were treated with posaconazole. Clinical information and the results of monitoring trough serum posaconazole concentrations were retrieved.
RESULTS
RESULTS
Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10 mg/kg per day of posaconazole. Six of 8 dogs recovered or developed clinical remission while administered posaconazole. Thirteen serum concentrations from 8 dogs tested were >1 μg/mL (range, 1.52 to >6 μg/mL) and the drug was well-tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis.
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Posaconazole should be considered as a treatment option for dogs with refractory coccidioidomycosis. Monitoring of indicators of liver function or injury along with therapeutic drug monitoring is recommended to tailor dosage in the event of hepatic toxicosis.
Identifiants
pubmed: 34658074
doi: 10.1111/jvim.16282
pmc: PMC8692207
doi:
Substances chimiques
Antifungal Agents
0
Triazoles
0
posaconazole
6TK1G07BHZ
Fluconazole
8VZV102JFY
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2772-2777Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.
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