Related Experiment Video
Updated: Sep 29, 2025
Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians
Published on: March 14, 2014
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.
Abstract:
This work’s objective was to evaluate the safety of isavuconazole (ISA) as a treatment or prophylaxis for invasive fungal infections (IFIs) in immunocompromised children. IFI was reported as proven or probable according to international definitions. Therapeutic drug monitoring was performed using mass tandem spectrometry to quantify trough plasma concentrations. Targeted ISA levels were 2−4 mg/L, as reported in adult series. Nine patients received ISA as a curative treatment, and six received ISA as prophylaxis. IFIs were proven in four cases and probable in five. The median ISA trough plasma concentration in curative use was 3.19 mg/L [0.88;5.00], and it was 2.94 mg/L [2.77;3.29] in the prophylactic use. The median durations of treatment were 81 days [15;276] and 95 days [15;253], respectively. Three patients had elevated aspartate aminotransferase and alanine aminotransferase, and three patients had elevated creatinine serum. The IFI response was satisfactory in all cases at day 90. No side effects were reported. No patients developed an IFI. Our data underline the safety of an ISA 100 mg dosing regimen in children of <30 kg, which we recommend in this fragile population. We suggest that ISA plasma levels are monitored 10 days after ISA initiation and then every two weeks, alongside guided therapeutic drug monitoring (TDM) administration.
Insights
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.
More Related Videos
06:14Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients
Published on: October 15, 2017
12:29Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus
Published on: April 19, 2017
Related Concept Videos
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
01:15Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
01:01Dosage Regimen: Fixed Dose
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
01:24Cystic Fibrosis: Management
Sinus disease and chronic...
01:25Routes of Drug Administration: Parenteral
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
01:29Drugs for Treatment of Ulcerative Colitis in IBD