Letermovir successfully used for secondary prophylaxis in a heart transplant recipient with ganciclovir‐resistant cytomegalovirus syndrome (UL97 mutation).

Letermovir was approved by the Food and Drug Administration (FDA) in November 2017 for use in adult cytomegalovirus (CMV)‐seropositive allogeneic stem cell transplant (SCT) recipients for primary prophylaxis of CMV infection and disease. We report off‐label use of letermovir for secondary prophylaxis of genotype‐confirmed ganciclovir‐resistant cytomegalovirus (CMV) syndrome (UL 97 mutation [C603W]) in a heart transplant recipient initially treated with intravenous cidofovir followed by foscarnet, both discontinued due to unacceptable toxicities. [ABSTRACT FROM AUTHOR]