Both peak and trough plasma levels of isavuconazole were significantly lower among patients with a body mass index (BMI) ≥25. In total, 31.7% of the C min values of the total cohort were below the plasma target concentrations of 1 μg/ml, defined as EUCAST antifungal clinical breakpoint for Aspergillus fumigatus. Overall, 223 isavuconazole levels of 41 patients were analysed, divided into 141 peak levels and 82 trough levels. Plasma levels 0-4 h after last dosing were defined as peak levels (C max ), those 20-28 h after last dosing as trough levels (C min ). Retrospective analysis of isavuconazole plasma concentrations were obtained as part of routine therapeutic drug monitoring (TDM) of ICU patients with invasive aspergillosis or other fungal infections treated with isavuconazole. Plasma concentrations of isavuconazole were determined in critically ill ICU patients while considering different patients' characteristics. Data regarding human plasma concentrations in clinical routine of the drug are rare. The broad-spectrum triazole isavuconazole is used for the treatment of invasive aspergillosis and mucormycosis.
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