Pediatric patients with hematologic malignancies and those undergoing hematopoietic stem cell transplantation are at substantial risk of invasive fungal diseases. Isavuconazole has several pharmacologic features that make it an appealing candidate in this setting, including broad-spectrum activity, favorable oral bioavailability, and a potentially more manageable interaction profile compared with other triazoles. However, pediatric evidence is still scarce, especially regarding its use as primary prophylaxis and its pharmacokinetic behavior in real-world clinical practice. Our study reports a retrospective clinical and pharmacokinetic evaluation of isavuconazole used as primary antifungal prophylaxis in a cohort of high-risk pediatric hematology patients managed within a structured stewardship framework. The manuscript includes detailed therapeutic drug monitoring data, safety assessment, and clinical outcomes, providing novel information on exposure predictability, dose stability, and tolerability in children.
Baccelli et al. (Mon,) studied this question.
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