Failure of posaconazole therapy in a renal transplant patient with invasive aspergillosis due to Aspergillus fumigatus with attenuated susceptibility to posaconazole

Kuipers, S.; Brüggemann, R.J.M.; de Sévaux, R.G.L.; Heesakkers, J.P.F.A.; Melchers, W.J.G.; Mouton, J.W.; Verweij, P.E.

Antimicrobial Agents and ChemoTherapy 55(7): 3564-3566


ISSN/ISBN: 1098-6596
PMID: 21502625
DOI: 10.1128/aac.01544-10
Accession: 036123233

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We report the case of a kidney transplant recipient with invasive aspergillosis due to Aspergillus fumigatus resistant to voriconazole and intermediately susceptible to posaconazole who failed posaconazole therapy. Plasma posaconazole concentrations indicated an unfavorable ratio of the area under the concentration-time curve over the MIC. Posaconazole should be used with caution for invasive aspergillosis caused by strains with attenuated posaconazole susceptibility, as drug exposure may be inadequate, resulting in therapeutic failure.