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Isavuconazole Treatment for Invasive Fungal Infections in Pediatric Patients
Philippe Zimmermann1, Benoit Brethon2, Julie Roupret-Serzec1
1Department of Pharmacy, University Robert Debre Hospital, AP-HP, 75019 Paris, France.
Isavuconazole (ISA) is safe for treating and preventing invasive fungal infections (IFIs) in immunocompromised children. This study recommends a 100 mg ISA regimen for children under 30 kg, with regular therapeutic drug monitoring.
Area of Science:
- Pediatric Infectious Diseases
- Mycology
- Pharmacology
Background:
- Invasive fungal infections (IFIs) pose a significant threat to immunocompromised children.
- Limited data exists on the safety and efficacy of isavuconazole (ISA) in pediatric populations.
- Establishing safe and effective antifungal treatments is crucial for this vulnerable group.
Purpose of the Study:
- To evaluate the safety and efficacy of isavuconazole (ISA) for treating or preventing IFIs in immunocompromised children.
- To determine appropriate dosing and therapeutic drug monitoring (TDM) strategies for ISA in pediatric patients.
- To assess ISA's pharmacokinetic profile in children.
Main Methods:
- A prospective study involving nine patients receiving ISA for curative treatment and six for prophylaxis.
- IFIs were diagnosed as proven or probable based on international definitions.
- Therapeutic drug monitoring using mass spectrometry quantified trough plasma concentrations, targeting 2–4 mg/L.
Main Results:
- Median ISA trough plasma concentrations were 3.19 mg/L for curative use and 2.94 mg/L for prophylaxis.
- Satisfactory IFI response was observed in all patients by day 90.
- Transient elevations in liver enzymes and creatinine occurred in a few patients; no serious side effects or new IFIs were reported.
Conclusions:
- A 100 mg ISA dosing regimen is safe and effective for children under 30 kg with IFIs.
- Regular therapeutic drug monitoring (TDM) is recommended for ISA in pediatric patients.
- ISA represents a promising option for managing IFIs in immunocompromised children.
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