Therapeutic drug concentrations of isavuconazole following the administration of isavuconazonium sulfate capsules via gastro-jejunum tube: A case report
Therapeutic drug concentrations of isavuconazole following the administration of isavuconazonium sulfate capsules via gastro-jejunum tube: A case report
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DOI：
10.1111/tid.13048
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发表时间：
2019-04-01
影响因子：
2.6
通讯作者：
Gandhi, Ronak G.
中科院分区：
文献类型：
--
作者：
Adamsick, Meagan L.;Elshaboury, Ramy H.;Gandhi, Ronak G.
侵袭性真菌感染是免疫功能低下患者（例如器官移植受者）的常见并发症。艾沙康唑是一种广谱唑类抗真菌药，用于治疗曲霉病和毛霉菌病。艾沙康唑的包装说明书建议不要打开胶囊通过肠内饲管给药。我们描述了一名 68 岁男性的病例，其肺移植后病程复杂，接受艾沙康唑治疗，通过胃造口-空肠造口管（G-J 管）治疗疑似侵袭性曲霉病（支气管肺泡灌洗半乳甘露聚糖指数 >3.75）。进行治疗药物监测以确保适当的吸收。在治疗过程的早期和晚期测量峰浓度和谷浓度，得出谷浓度为 2.7 mcg/mL 和 4.0 mcg/mL，这与之前公布的艾沙康唑胶囊完整给药时的谷浓度一致。该病例报告表明，打开艾沙康唑胶囊并通过 G-J 管给药可产生与完整胶囊相当的适当吸收和血清药物水平。
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.