ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1592767
Real-world correlation between therapeutic drug monitoring and clinical outcomes of the antifungal drug posaconazole: a single-center retrospective cohort study
Provisionally accepted
Qiaoyan YiLin DongPeng WangYinpin ShiYilei Yang
Zhonghua DongSiwen Li
Yan LI
Xin HuangJinjuan Liu
Haiyan Shi*Hongmei Wang*- Shandong Provincial Qianfoshan Hospital, Jinan, China
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Objective: Posaconazole is a first-line drug for preventing invasive fungal disease (IFD) in patients undergoing haematopoietic stem cell transplantation (HSCT). Few retrospective studies have examined the impact of therapeutic drug monitoring (TDM) on preventing IFD with posaconazole. This study was designed to evaluate the efficacy, safety, and cost-effectiveness of posaconazole in preventing IFD based on real-world data. Methods: This single-centre, retrospective cohort study analyzed the use of posaconazole for fungal prophylaxis in HSCT patients at the First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital). Patients were classified into TDM and non-TDM groups based on their TDM status. Clinical data were analyzed using propensity score matching (PSM) to further elucidate the role of TDM in posaconazole prophylaxis. Results: After PSM, the prophylactic success rate was significantly higher in the TDM group (100%) than in the non-TDM group (52.9%) (P=0.003). There was no statistically significant difference in gastrointestinal, hepatic and renal adverse effects between the two groups (P>0.05). Both the total cost of treatment and the cost of medication were lower in the TDM group compared to the non-TDM group. Conclusion: Real-world data demonstrate that TDM enhances the effectiveness of posaconazole in preventing IFD in HSCT patients and moderately reduces treatment costs.
Keywords: Posaconazole, Therapeutic drug monitoring, Invasive fungal disease, Prophylactic Antifungal Therapy, Hematopoietic Stem Cell Transplantation
Received: 13 Mar 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Yi, Dong, Wang, Shi, Yang, Dong, Li, LI, Huang, Liu, Shi and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haiyan Shi, Shandong Provincial Qianfoshan Hospital, Jinan, China
Hongmei Wang, Shandong Provincial Qianfoshan Hospital, Jinan, China
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