Clinical and demographic factors affecting trough levels of isavuconazole in critically ill patients with or without COVID‐19

BackgroundThe broad‐spectrum antifungal isavuconazole is administered to treat invasive aspergillosis and mucormycosis.ObjectivesIsavuconazole plasma concentrations in critically ill ICU patients with or without COVID‐19 and invasive fungal infection were determined, and factors for sub‐therapeutic drug levels ( 25 (p = .006), SOFA score > 12 (p = .026), RRT (p = .017) and ECMO requirement (p = .001).ConclusionsIsavuconazole plasma levels can be negatively affected by patients' risk factors, supportive renal replacement and ECMO therapy. Future prospective studies analysing the relevance of isavuconazole drug levels in ICU patient outcome are urgently needed.