Intricate isavuconazole therapy of a subcutaneous nodule caused by Alternaria infectoria in a heart transplant recipient

Isavuconazole for Treating Invasive Mould Disease in Solid Organ Transplant Recipients

“…It was decided to increase the daily dose of isavuconazole to 200 mg every 12 h. Isavuconazole blood levels arose to therapeutic range afterwards [16]. Another patient with isavuconazole trough levels of 7.2 mg/L, required the withdraw of the antifungal drug due to multiple side effects [19]. Two retrospective studies which included 55 and 26 SOT recipients that received isavuconazole as prophylaxis, and had TDM performed for both isavuconazole and tacrolimus, concluded that the interaction between these drugs was more significant after liver transplantation, that the impact of isavuconazole on tacrolimus levels varied between individuals and that a moderate interpatient variability in isavuconazole pharmacokinetic parameters could be observed [35,36].…”

“…We identified 20 studies which included at least one SOT recipient who received isavuconazole as treatment for an IMD (Figure 1). Overall, 13 studies met the inclusion criteria, including one prospective observational study which described 53 SOT recipients treated with isavuconazole for fungal infections [15], one multicenter retrospective study with 81 SOT recipients with proven or probable IMD treated with isavuconazole for ≥24 h as first-line or salvage therapy [16], and eleven case reports [17][18][19][20][21][22][23][24][25][26][27]. One case report was not included as it lacked most data related to the transplantation and six studies were excluded as they included both SOT and patients with hematologic malignancies and stem cell transplantation.…”