Lack of evidence for exposure–response relationship in the use of posaconazole as prophylaxis against invasive fungal infections
Cornely OA, Ullmann AJ
Whether or not to monitor serum concentrations of antifungal agents such as posaconazole continues to present clinicians with a clinical quandary. A recent publication supported the use of serum concentrations to guide dose modifications for posaconazole in an effort to optimize prophylactic therapy . This Letter to the Editor of the Clinical Pharmacology & Therapeutics journal refutes this recommendation on the basis of disagreement with one of the study endpoints. Disagreements such as this highlight how little we actually know about antifungal exposure and its relationship to patient outcomes.