Isavuconazole in the management of central nervous system fungal infections: Parenchymal penetration and clinical performance.

Isavuconazole shows efficient brain penetration in animal models (brain-to-plasma ratios 0.42 to 1.8) and is linked to clinical responses in cerebral aspergillosis.

• Why it matters: CNS invasive fungal infections carry high mortality and are limited by blood-brain barrier–restricted drug exposure, creating a need for agents that reach brain tissue.
• What they did: This review synthesizes isavuconazole pharmacokinetics and clinical performance, including animal brain-to-plasma ratios (0.42 to 1.8) and human outcomes in cerebral aspergillosis.
• The result: In cerebral aspergillosis, response was associated with 70% of first-line patients (n=10) and 73% of salvage-treated patients (n=30), supporting its use while awaiting randomized confirmation for first-line CNS infection.

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