{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:10:29Z","timestamp":1784124629692,"version":"3.55.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020537","name":"Merck Sharp & Dohme Australia","doi-asserted-by":"publisher","award":["MSD-IIS-55730"],"award-info":[{"award-number":["MSD-IIS-55730"]}],"id":[{"id":"10.13039\/100020537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1133479"],"award-info":[{"award-number":["APP1133479"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Posaconazole prophylaxis is indicated in high-risk patients with haematological malignancies to prevent invasive fungal diseases (IFDs) with guidelines advising steady-state posaconazole plasma concentrations (PPCs) above 0.5\u20130.7\u2005mg\/L. Therapeutic drug monitoring (TDM), however, is not routinely recommended for posaconazole delayed-release tablet (DRT) prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe PPCs in hospitalized high-risk patients with haematological malignancies treated for AML or undergoing allogeneic haematopoietic cell transplantation receiving posaconazole prophylaxis with posaconazole DRT and factors influencing exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This prospective, two-centre cohort study measured serial PPCs at Days 7, 14 and 21, and during diarrhoea episodes in adult high-risk patients receiving prophylaxis with posaconazole DRT between August 2019 and May 2023. Patients were followed during hospital admission and for 7\u2005days after the last dose of posaconazole or hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-two patients contributed 223 PPCs. Subtherapeutic PPCs (&amp;lt;0.7\u2005mg\/L) occurred in 77 (34.5%) samples and 49 (53.3%) patients recorded \u22651 subtherapeutic PPC. The median Day 7 PPC was 0.84 (IQR: 0.47\u20131.16) mg\/L, with no significant changes over time. In patients with diarrhoea compared with no diarrhoea, the median PPC was significantly lower [0.74 (IQR: 0.48\u20131.00) mg\/L versus 0.92 (IQR: 0.64\u20131.40) mg\/L, P\u200a=\u200a0.007]. Multivariate analysis identified older age (&amp;gt;60\u2005years) was protective against subtherapeutic PPCs. Six IFDs developed in five patients (5.4%) during follow-up and posaconazole-attributed hepatotoxicity resulted in cessation for one patient (1.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subtherapeutic PPCs are common during posaconazole DRT prophylaxis, suggesting the need for routine TDM to optimize dosing in those receiving this posaconazole formulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag233","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:22:01Z","timestamp":1784121721000},"source":"Crossref","is-referenced-by-count":0,"title":["Subtherapeutic posaconazole exposure during delayed-release tablet prophylaxis in high-risk patients with haematological malignancies: rationale for routine therapeutic drug 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Parkville, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Page","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, National Health and Medical Research Council Centre of Research Excellence, Peter MacCallum Cancer Centre, Department of Oncology, University of Melbourne , Parkville, VIC ,","place":["Australia"]},{"name":"Infectious Diseases Unit, Peter MacCallum Cance Centre , Parkville, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelle","family":"Stewart","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer, National Health and Medical Research Council Centre of Research Excellence, Peter MacCallum Cancer Centre, Department of Oncology, University of Melbourne , Parkville, VIC ,","place":["Australia"]},{"name":"Infectious Diseases Unit, Peter MacCallum Cance Centre , Parkville, VIC 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,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Fong","sequence":"additional","affiliation":[{"name":"Clinical Haematology Department, Austin Health , Heidelberg, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5111-6367","authenticated-orcid":false,"given":"Jason A","family":"Trubiano","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Immunology, Austin Health , Heidelberg, VIC ,","place":["Australia"]},{"name":"Department of Infectious Diseases, University of Melbourne, the Peter Doherty Institute for Immunity and Infection , Melbourne, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-9060","authenticated-orcid":false,"given":"David C M","family":"Kong","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, 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