OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press54410.17650/1818-8346-2022-17-2-121-133SUPPORTIVE THERAPY ASPECTSАСПЕКТЫ ПОДДЕРЖИВАЮЩЕЙ ТЕРАПИИIntravenous posaconazole: key features of clinical pharmacology and practical applicationsВнутривенная форма позаконазола: ключевые особенности клинической фармакологии и практического примененияhttps://orcid.org/0000-0003-4683-1566VeselovA. V.ВеселовА. В.
Russian Federation

214019, Smolensk, Krupskoy St., 28

214019 Смоленск, ул. Крупской, 28

https://orcid.org/0000-0001-6095-7531KlimkoN. N.КлимкоН. Н.
Russian Federation

191015, Saint-Petersburg, Kirochnaya St., 41

191015 Санкт-Петербург, ул. Кирочная, 41

n_klimko@mail.ruInstitute of Antimicrobial Chemotherapy, Smolensk State Medical University, Ministry of Health of RussiaНаучно-исследовательский институт антимикробной химиотерапии ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава РоссииI.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России140420221721211331404202214042022https://oncohematology.abvpress.ru/ongm/article/view/544

Invasive fungal infections in various categories of patients remain one of the most urgent problems of modern medicine. This is complicated by the imperfection of diagnostic methods, as well as a small range of antimycotics for systemic use. The market launch in 2005 of posaconazole, a second-generation systemic antimycotic from the group of triazoles with a wide spectrum of activity in the form of an oral suspension, was an event in medical mycology. However, pharmacokinetic features of suspension have caused certain problems with its use. The suspension was replaced by a tablet form, largely devoid of these shortcomings, and then a solution for intravenous administration, which was registered in Russia at the end of 2021 (significantly later than in other countries of the world). Registration of an intravenous form of the drug with the possibility of using both for a stepdown approach and in patients who, for different reasons, cannot take posaconazole orally, had a positive impact on the problem of choosing antimycotics for the prophylaxis and treatment of invasive fungal infections. In this article, we will consider the features of the clinical pharmacology of the intravenous form and its place in the prophylaxis and treatment of invasive mycoses.

Инвазивные грибковые инфекции у различных категорий пациентов остаются актуальной проблемой современной медицины. Проблема осложняется несовершенством методов диагностики, а также небольшим выбором антимикотиков для системного применения. Появление на рынке в 2005 г. позаконазола, системного антимикотика из группы триазолов 2-го поколения с широким спектром активности в виде суспензии для приема внутрь, стало событием в медицинской микологии. Однако особенности фармакокинетики суспензии обусловили определенные сложности при ее применении. На смену суспензии пришла таблетированная форма, в значимой степени лишенная этих недостатков, а далее – раствор для внутривенного введения, который был зарегистрирован в России в конце 2021 г. (позднее, чем во многих других странах мира). Регистрация внутривенной формы препарата с возможностью использования как для ступенчатого подхода, так и у пациентов, у которых нет возможности приема позаконазола внутрь, оказала положительное влияние на решение проблемы выбора антимикотиков для профилактики и терапии инвазивных грибковых инфекций. В настоящей статье мы рассмотрим особенности клинической фармакологии лекарственной формы для внутривенного введения и ее место в профилактике и терапии инвазивных микозов.

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