ArticleFrontiers in cellular and infection microbiology2026
Exploratory model-based optimizing isavuconazole dosing regimens for
Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Serum albumin strongly influences isavuconazole pharmacokinetics due to its high plasma protein binding. Hypoalbuminemia, common in critically ill and immunocompromised patients, may cause subtherapeutic concentrations with standard isavuconazole dosage. This study aimed to optimize isavuconazole dosing regimens against Methods: A published population pharmacokinetic model of isavuconazole was used to simulate four dosing regimens stratified by serum albumin levels. Monte Carlo simulations calculated probability of target attainment (PTA) and cumulative fraction of response (CFR) based on the area under the concentration-time curve/minimum inhibitory concentration (AUC/MIC) ratios, with separate targets for immunocompetent and immunocompromised patients. PTA or CFR > 90% was considered optimal for a dosing regimen. Results: Based on PTA analysis for Conclusions: These PK/PD simulations support isavuconazole dose optimization for hypoalbuminemic adults with aspergillosis and require prospective clinical validation.
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