Therapeutic and Pharmacokinetic Challenges with Treatment of Nontuberculous Mycobacteria Infection in a Lung Transplant Recipient: A Case Series (ATC 2026) - Jun 17, 2026 - Abstract #Abstract D325; Pres time: Jun 23, 2026; 02:30 PM - 03:30 PM; Location: Exhibit Hall; "This presents a challenge when managing immunosuppression and infection prophylaxis post-LTx due to drug-drug interactions (DDIs) with antimycobacterial agents.* We present a case series of two LTx recipients requiring concomitant rifabutin for NTM treatment and isavuconazole for post-LTx fungal prophylaxis and describe the pharmacokinetic effects of both drugs.* A 62-year-old male was diagnosed pre-LTx with pulmonary (MAC) infection and initiated on rifabutin, azithromycin, and ethambutol. This case series adds to the limited data available describing the pharmacokinetic interaction between isavuconazole and rifabutin in a transplant recipient. Therapeutic drug monitoring with the appropriate timing from initiation of CYP3A4 inducers may be necessary to confirm therapeutic serum concentrations. The effect of interpatient variability in CYP3A4 metabolism on response to enzyme induction or inhibition should be further evaluated."
Clinical • Nontuberculous mycobacteria • PK/PD data • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases • Transplantation • CYP3A4
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R. Jung 1; A. Ali 1; T. Royer 2; M. Tucker 2; N. Sinha 3
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