{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:30:56Z","timestamp":1787639456579,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":1572,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>Eight dogs with refractory coccidioidomycosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10\u00a0mg\/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 &amp;gt;1\u00a0\u03bcg\/mL (range, 1.52 to &amp;gt;6\u00a0\u03bcg\/mL) and the drug was well-tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.16282","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T14:34:52Z","timestamp":1634740492000},"page":"2772-2777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Posaconazole treatment of refractory coccidioidomycosis in dogs"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1011-0708","authenticated-orcid":false,"given":"Lisa F.","family":"Shubitz","sequence":"first","affiliation":[{"name":"Valley Fever Center for Excellence, The University of Arizona , Tucson, Arizona,","place":["USA"]},{"name":"Veterinary Specialty Center of Tucson , Tucson, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallianne","family":"Schlacks","sequence":"additional","affiliation":[{"name":"Veterinary Specialty Center of Tucson , Tucson, Arizona,","place":["USA"]},{"name":"University of Arizona College of Veterinary Medicine , Oro Valley, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polina","family":"Vishkautsan","sequence":"additional","affiliation":[{"name":"Veterinary Specialty Center of Tucson , Tucson, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine D.","family":"Butkiewicz","sequence":"additional","affiliation":[{"name":"Valley Fever Center for Excellence, The University of Arizona , Tucson, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate A.","family":"Worthing","sequence":"additional","affiliation":[{"name":"University of Arizona\u2009College of Veterinary Medicine , Oro Valley, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"2026022001343371400_jvim16282-bib-0001","doi-asserted-by":"crossref","first-page":"226","DOI":"10.5326\/0440226","article-title":"Coccidioidomycosis in dogs and cats: a review","volume":"44","author":"Graupmann-Kuzma","year":"2008","journal-title":"J Am Anim Hosp Assoc"},{"key":"2026022001343371400_jvim16282-bib-0002","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2460\/javma.2003.222.461","article-title":"Clinical, clinicopathologic, and radiographic findings in dogs with coccidioidomycosis: 24 cases (1995-2000)","volume":"222","author":"Johnson","year":"2003","journal-title":"J Am Vet Med Assoc"},{"key":"2026022001343371400_jvim16282-bib-0003","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1053\/j.ctsap.2005.07.002","article-title":"Coccidioidomycosis: A diagnostic challenge","volume":"20","author":"Shubitz","year":"2005","journal-title":"Clin Tech Small Anim Pract"},{"key":"2026022001343371400_jvim16282-bib-0004","first-page":"613","article-title":"Canine and Feline Infectious Diseases","author":"Sykes","year":"2014","edition":"1st ed."},{"key":"2026022001343371400_jvim16282-bib-0005","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1086\/430303","article-title":"Refractory coccidioidomycosis treated with posaconazole","volume":"40","author":"Anstead","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2026022001343371400_jvim16282-bib-0006","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1093\/cid\/cir642","article-title":"Treatment of refractory coccidioidomycosis with voriconazole or posaconazole","volume":"53","author":"Kim","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2026022001343371400_jvim16282-bib-0007","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1086\/507891","article-title":"New agents for the treatment of fungal infections: clinical efficacy and gaps in coverage","volume":"43","author":"Spanakis","year":"2006","journal-title":"Clin Infect Dis"},{"key":"2026022001343371400_jvim16282-bib-0008","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.2165\/11596540-000000000-00000","article-title":"Triazole antifungal agents in invasive fungal infections: a comparative review","volume":"71","author":"Lass-Florl","year":"2011","journal-title":"Drugs"},{"key":"2026022001343371400_jvim16282-bib-0009","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/j.1365-2125.2010.03680.x","article-title":"Clinical pharmacodynamics and pharmacokinetics of the antifungal extended-spectrum triazole posaconazole: an overview","volume":"70","author":"Lipp","year":"2010","journal-title":"Br J Clin Pharmacol"},{"key":"2026022001343371400_jvim16282-bib-0010","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1086\/519937","article-title":"Safety, tolerance, and efficacy of posaconazole therapy in patients with nonmeningeal disseminated or chronic pulmonary coccidioidomycosis","volume":"45","author":"Catanzaro","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2026022001343371400_jvim16282-bib-0011","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1128\/AAC.46.5.1352-1356.2002","article-title":"In vitro and in vivo activities of posaconazole against Coccidioides immitis","volume":"46","author":"Gonzalez","year":"2002","journal-title":"Antimicrob Agents Chemother"},{"key":"2026022001343371400_jvim16282-bib-0012","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1093\/jac\/dkt508","article-title":"Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology","volume":"69","author":"Ashbee","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"2026022001343371400_jvim16282-bib-0013","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1128\/AAC.41.7.1558","article-title":"Activity of the triazole SCH 56592 against disseminated murine coccidioidomycosis","volume":"41","author":"Lutz","year":"1997","journal-title":"Antimicrob Agents Chemother"},{"key":"2026022001343371400_jvim16282-bib-0014","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1093\/cid\/cir734","article-title":"Posaconazole for chronic refractory coccidioidal meningitis","volume":"53","author":"Schein","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2026022001343371400_jvim16282-bib-0015","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/jvim.13795","article-title":"Treatment of disseminated aspergillosis with posaconazole in 10 dogs","volume":"30","author":"Corrigan","year":"2016","journal-title":"J Vet Intern Med"},{"key":"2026022001343371400_jvim16282-bib-0016","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/jsap.12686","article-title":"Treatment of refractory sino-nasal aspergillosis with posaconazole and terbinafine in 10 dogs","volume":"58","author":"Stewart","year":"2017","journal-title":"J Small Anim Pract"},{"key":"2026022001343371400_jvim16282-bib-0017","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/j.1749-6632.1988.tb40443.x","article-title":"Treatment of mycoses with itraconazole","volume":"544","author":"Tucker","year":"1988","journal-title":"Ann N Y Acad Sci"},{"key":"2026022001343371400_jvim16282-bib-0018","first-page":"569","article-title":"Kirk's Current Veterinary Therapy","author":"Webster","year":"2014","edition":"15th ed."},{"key":"2026022001343371400_jvim16282-bib-0019","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0022-5223(19)39029-4","article-title":"Coccidioidal pulmonary cavities with rupture","volume":"84","author":"Cunningham","year":"1982","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026022001343371400_jvim16282-bib-0020","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.mmcr.2016.01.002","article-title":"Disseminated Chrysosporium infection in a German shepherd dog","volume":"10","author":"Cook","year":"2015","journal-title":"Med Mycol Case Rep"},{"key":"2026022001343371400_jvim16282-bib-0021","doi-asserted-by":"crossref","first-page":"381","DOI":"10.2460\/javma.242.3.381","article-title":"Disseminated mycotic infection caused by Westerdykella species in a German shepherd dog","volume":"242","author":"Armentano","year":"2013","journal-title":"J Am Vet Med Assoc"},{"key":"2026022001343371400_jvim16282-bib-0022","doi-asserted-by":"crossref","first-page":"379","DOI":"10.2165\/11319340-000000000-00000","article-title":"Pharmacokinetic\/pharmacodynamic profile of posaconazole","volume":"49","author":"Li","year":"2010","journal-title":"Clin Pharmacokinet"},{"key":"2026022001343371400_jvim16282-bib-0023","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/bcpt.13093","article-title":"Impact of patient education on plasma concentrations and effectiveness of posaconazole oral suspension under clinical conditions","volume":"124","author":"Geist","year":"2019","journal-title":"Basic Clin Paharmacol Toxicol"},{"key":"2026022001343371400_jvim16282-bib-0024","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1046\/j.1365-2125.2003.01977.x","article-title":"Effect of food on the relative bioavailability of two oral formulations of posaconazole in healthy adults","volume":"57","author":"Courtney","year":"2004","journal-title":"Br J Clin Pharmacol"},{"key":"2026022001343371400_jvim16282-bib-0025","doi-asserted-by":"crossref","first-page":"454","DOI":"10.2460\/ajvr.76.5.454","article-title":"Posaconazole pharmacokinetics after administration of an intravenous solution, oral suspension, and delayed-release tablet to dogs","volume":"76","author":"Kendall","year":"2015","journal-title":"Am J Vet Res"},{"key":"2026022001343371400_jvim16282-bib-0026","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s40265-019-01127-8","article-title":"Adverse effects associated with long-term administration of azole antifungal agents","volume":"79","author":"Benitez","year":"2019","journal-title":"Drugs"},{"key":"2026022001343371400_jvim16282-bib-0027","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1128\/CMR.00005-13","article-title":"Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis","volume":"26","author":"Nguyen","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"2026022001343371400_jvim16282-bib-0028","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1053\/j.ctsap.2005.07.005","article-title":"An overview of antifungal drugs and their use for treatment of deep and superficial mycosis in animals","volume":"20","author":"Hector","year":"2005","journal-title":"Clin Tech Small Anim Pract"},{"key":"2026022001343371400_jvim16282-bib-0029","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1093\/jac\/dkx122","article-title":"Multicentre study of posaconazole delayed-release tablet serum level and association with hepatotoxicity and QTc prolongation","volume":"72","author":"Pettit","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2026022001343371400_jvim16282-bib-0030","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s12281-016-0255-4","article-title":"Therapeutic drug monitoring of posaconazole: an update","volume":"10","author":"Dekkers","year":"2016","journal-title":"Curr Fungal Infect Rep"},{"key":"2026022001343371400_jvim16282-bib-0031","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1647\/1082-6742-34.1.52","article-title":"Preliminary pilot study of itraconazole after a single oral dose of a veterinary formulation solution in African penguins (Spheniscus demersus)","volume":"34","author":"Zalesak","year":"2020","journal-title":"J Avian Med Surg"}],"updated-by":[{"DOI":"10.1111\/jvim.16393","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000}}],"container-title":["Journal of Veterinary Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvim.16282","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvim.16282","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/35\/6\/2772\/67007747\/jvim16282.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/35\/6\/2772\/67007747\/jvim16282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:34:43Z","timestamp":1771569283000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jvim\/article\/35\/6\/2772\/8492650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jvim.16282","relation":{},"ISSN":["1939-1676"],"issn-type":[{"value":"1939-1676","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11]]},"published":{"date-parts":[[2021,11,1]]},"assertion":[{"value":"2021-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}