Mucormycosis is a rare invasive fungal disease diagnosed in immunocompromised patients, including those with diabetes or iron overload, and in patients treated for hematological malignancies or after transplantation. Isavuconazole is a triazole antifungal effective against Mucorales with good tolerability, but with potential for relatively high interindividual variability in pharmacokinetics. This report demonstrates the case of a lung transplant recipient treated with isavuconasole that exhibits a very long elimination half-life of 159 hours, and discusses the practical implications of this finding for dosage adjustment and need for therapeutic drug monitoring.

Department of Medical Chemistry and Clinical Biochemistry 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Institute of Pharmacology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Prague Lung Transplant Program 3rd Department of Surgery 1st Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Prague Lung Transplant Program Department of Pneumology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

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