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Posaconazole, a prophylactic therapy in patients with haematological cancer: drug use evaluation study
  1. Dalia A Hamdy1,2,
  2. Samah El-Salem1,
  3. Hager El-Geed1,
  4. Manal Zaidan3
  1. 1College of Pharmacy, Qatar University, Doha, Qatar
  2. 2Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
  3. 3National Centre for Cancer Care & Research (NCCCR) and Heart Hospital, Hamad Medical Corporation, Doha, Qatar
  1. Correspondence to Dr Dalia A Hamdy, Faculty of Pharmacy, Alexandria University, 1 El Khartoum Square, PO Box 21521, Alexandria, Egypt; dr.daliahamdy{at}gmail.com

Abstract

Background Posaconazole (PSZ), is an antifungal prophylactic therapy that is used in haematological cancer patients. In 2010, PSZ was added to the formulary of the National Centre for Cancer Care & Research (NCCCR), the only adult cancer hospital in Qatar.

Objective To conduct a drug use evaluation (DUE) study of PSZ at NCCCR.

Method A retrospective, single centred, observational DUE study was conducted to include a convenient sample of haematological cancer patients who used PSZ prophylactically in 2010. All 31 patients were nominated; 20 patients profiles were reviewed. Data were collected using a pre-prepared collection sheet and descriptive analysis was performed.

Results One patient was excluded as he was not a haematological cancer patient. All remaining 19 patients received PSZ for prophylaxis and were compliant. More than 50% of patients received proton pump inhibitors concurrently with PSZ. Only 1 case had a recorded recommendation regarding the administration of PSZ with food. Five patients received a vincristine based chemotherapy protocol, one of which developed seizures. Two patients developed mild breakthrough fungal infection while on PSZ.

Conclusions The PSZ practice in NCCCR abides by its regulations of use. However, clear recommendations regarding administration of PSZ with meals is essential. PSZ co-administration with proton pump inhibitors should be either stopped or managed by PSZ therapeutic drug monitoring to avoid PSZ sub-therapeutic levels. Possible serious drug interactions in patients treated with vincristine based chemotherapy should be highlighted and monitored.

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