Demonstration of the Rationale for Therapeutic Drug Monitoring of Isavuconazole: A Case Report with a Lung Transplant Recipient

Prague Med Rep. 2023;124(4):444-448. doi: 10.14712/23362936.2023.34.

Abstract

Mucormycosis is a rare invasive fungal disease diagnosed in immunocompromised patients, including those with diabetes or iron overload, and in patients treated for hematological malignancies or after transplantation. Isavuconazole is a triazole antifungal effective against Mucorales with good tolerability, but with potential for relatively high interindividual variability in pharmacokinetics. This report demonstrates the case of a lung transplant recipient treated with isavuconasole that exhibits a very long elimination half-life of 159 hours, and discusses the practical implications of this finding for dosage adjustment and need for therapeutic drug monitoring.

Keywords: Antifungals; Isavuconazole; Lung transplant recipient; Pharmacokinetics; Therapeutic drug monitoring.

Publication types

  • Case Reports

MeSH terms

  • Aspergillosis* / drug therapy
  • Drug Monitoring
  • Humans
  • Lung
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy
  • Transplant Recipients
  • Triazoles / pharmacokinetics
  • Triazoles / therapeutic use

Substances

  • isavuconazole
  • Triazoles