The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube

Background: Invasive aspergillosis (IA) is an opportunistic infection that affects immunocompromised patients. While voriconazole is commonly used for IA treatment, it presents the risk of drug interactions, particularly in patients on polytherapy. Isavuconazole may serve as a safer alternative with...

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Main Authors: Álvaro Corral Alaejos, Jose Jiménez Casaus, Ángel López Delgado, Aranzazu Zarzuelo Castañeda
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:International Journal of Translational Medicine
Subjects:
Online Access:https://www.mdpi.com/2673-8937/4/4/44
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author Álvaro Corral Alaejos
Jose Jiménez Casaus
Ángel López Delgado
Aranzazu Zarzuelo Castañeda
author_facet Álvaro Corral Alaejos
Jose Jiménez Casaus
Ángel López Delgado
Aranzazu Zarzuelo Castañeda
author_sort Álvaro Corral Alaejos
collection DOAJ
description Background: Invasive aspergillosis (IA) is an opportunistic infection that affects immunocompromised patients. While voriconazole is commonly used for IA treatment, it presents the risk of drug interactions, particularly in patients on polytherapy. Isavuconazole may serve as a safer alternative with fewer interactions. However, the use of isavuconazole is typically limited to the parenteral route for patients without access to the enteral route, due to recommendations against tablet handling for enteral administration. The objective of this study was to evaluate the suitability of isavuconazole administration via an enteral tube, by therapeutic drug monitoring of isavuconazole plasma concentrations. Methods: This case study examines a patient with diffuse large B-cell lymphoma who was diagnosed with IA and treated with isavuconazole via an enteral tube. Therapeutic pharmacokinetic monitoring of isavuconazole plasma concentrations was performed to assess the feasibility and safety of enteral administration. Results: The results show that isavuconazole concentrations were maintained within the therapeutic range when administered via an enteral tube. No significant deviations in plasma concentration were noted during the monitoring period. Conclusions: Administering isavuconazole through an enteral tube is a safe and viable alternative for patients that are unable to receive the drug via the oral route. Therapeutic monitoring of plasma concentrations is recommended to ensure proper dosing and efficacy.
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spelling doaj-art-3dfd36451cd54b2eafbc51dc7c1c5ae72025-08-20T02:43:32ZengMDPI AGInternational Journal of Translational Medicine2673-89372024-11-014463163910.3390/ijtm4040044The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral TubeÁlvaro Corral Alaejos0Jose Jiménez Casaus1Ángel López Delgado2Aranzazu Zarzuelo Castañeda3Pharmacy. Complejo Asistencial de Zamora, Hospital Virgen de la Concha, Avda Requejo 35, 49022 Zamora, SpainPharmacy. Complejo Asistencial de Zamora, Hospital Virgen de la Concha, Avda Requejo 35, 49022 Zamora, SpainPharmacy. Complejo Asistencial de Zamora, Hospital Virgen de la Concha, Avda Requejo 35, 49022 Zamora, SpainDepartment of Pharmaceutical Sciences, Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, C. Lic. Méndez Nieto, s/n, 37007 Salamanca, SpainBackground: Invasive aspergillosis (IA) is an opportunistic infection that affects immunocompromised patients. While voriconazole is commonly used for IA treatment, it presents the risk of drug interactions, particularly in patients on polytherapy. Isavuconazole may serve as a safer alternative with fewer interactions. However, the use of isavuconazole is typically limited to the parenteral route for patients without access to the enteral route, due to recommendations against tablet handling for enteral administration. The objective of this study was to evaluate the suitability of isavuconazole administration via an enteral tube, by therapeutic drug monitoring of isavuconazole plasma concentrations. Methods: This case study examines a patient with diffuse large B-cell lymphoma who was diagnosed with IA and treated with isavuconazole via an enteral tube. Therapeutic pharmacokinetic monitoring of isavuconazole plasma concentrations was performed to assess the feasibility and safety of enteral administration. Results: The results show that isavuconazole concentrations were maintained within the therapeutic range when administered via an enteral tube. No significant deviations in plasma concentration were noted during the monitoring period. Conclusions: Administering isavuconazole through an enteral tube is a safe and viable alternative for patients that are unable to receive the drug via the oral route. Therapeutic monitoring of plasma concentrations is recommended to ensure proper dosing and efficacy.https://www.mdpi.com/2673-8937/4/4/44isavuconazolepharmacokineticsenteral tube
spellingShingle Álvaro Corral Alaejos
Jose Jiménez Casaus
Ángel López Delgado
Aranzazu Zarzuelo Castañeda
The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
International Journal of Translational Medicine
isavuconazole
pharmacokinetics
enteral tube
title The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
title_full The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
title_fullStr The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
title_full_unstemmed The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
title_short The Successful and Safe Real-Time TDM-Guided Treatment of Invasive Pulmonary Aspergillosis Using Isavuconazole Administered by Enteral Tube
title_sort successful and safe real time tdm guided treatment of invasive pulmonary aspergillosis using isavuconazole administered by enteral tube
topic isavuconazole
pharmacokinetics
enteral tube
url https://www.mdpi.com/2673-8937/4/4/44
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