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Therapeutic drug concentrations of isavuconazole following the administration of isavuconazonium sulfate capsules via gastro‐jejunum tube: A case report
Author(s) -
Adamsick Meagan L.,
Elshaboury Ramy H.,
Gift Thais,
Mansour Michael K.,
Kotton Camille N.,
Gandhi Ronak G.
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13048
Subject(s) - medicine , jejunum , gastro , drug , pharmacology , tube (container) , food and drug administration , gastroenterology , disease , reflux , mechanical engineering , engineering
Invasive fungal infections are a common complication in immunocompromised patients, such as organ transplant recipients. Isavuconazole is a broad‐spectrum azole antifungal for the treatment of aspergillosis and mucormycosis. The package insert for isavuconazole recommends against opening the capsule for administration through enteral feeding tubes. We describe the case of a 68‐year‐old man with a complex post‐lung transplant course receiving isavuconazole for presumed invasive aspergillosis (bronchial alveolar lavage galactomannan index of >3.75) therapy administered through a gastrostomy‐jejunostomy tube (G‐J tube). Therapeutic drug monitoring was performed to ensure appropriate absorption. Peak and trough concentrations were measured in the early and late phases of the treatment course and resulted in trough levels of 2.7 mcg/mL and 4.0 mcg/mL, which is consistent with previously published trough concentrations of isavuconazole when the capsule was administered intact. This case report suggests that opening isavuconazole capsules and administration through a G‐J tube results in appropriate absorption and serum drug levels comparable to intact capsules.