Review ArticlePosaconazole: The Case for Therapeutic Drug MonitoringHoward, Susan J PhD*; Felton, Timothy W MBBS*; Gomez-Lopez, Alicia PhD†; Hope, William W MBBS, PhD*Author Information From the *School of Translational Medicine, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom; and †Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain. Received for publication June 26, 2011; accepted October 12, 2011. W. W. Hope has received travel grants and research funding from Schering Plough. S. J. Howard and T. W. Felton have received travel grants from Schering-Plough. T. W. Felton is supported by a Medical Research Council Clinical Research Training Fellowship in Clinical Pharmacology. W. W. Hope is supported by a National Institute of Health Research (NIHR) Clinician Scientist Award. The other authors declare no conflict of interest. Correspondence: Susan J. Howard, PhD, School of Translational Medicine, The University of Manchester, Oxford Road, 1.800 Stopford Building, M13 9PT Manchester, United Kingdom (e-mail: [email protected]). Therapeutic Drug Monitoring: February 2012 - Volume 34 - Issue 1 - p 72-76 doi: 10.1097/FTD.0b013e31823cdeac Buy Metrics Abstract Invasive fungal infections are associated with high morbidity and mortality. Antifungal therapeutic options remain relatively limited; therefore, optimization of present regimens is essential. Posaconazole is licensed for prevention of invasive fungal infections and oropharyngeal candidiasis and salvage therapy for invasive aspergillosis. Recent data suggest that therapeutic drug monitoring may be an important tool for patient management. Clinical and laboratory animal data suggest that posaconazole demonstrates clinically relevant exposure–response relationships. Higher systemic drug exposure is associated with improved clinical outcomes. Potentially subtherapeutic concentrations are frequently encountered in critically ill patients. Therapeutic drug monitoring provides a way to optimize the use of posaconazole, and this review summarizes the indications and process by which this can be achieved. © 2012 Lippincott Williams & Wilkins, Inc.