Isavuconazole in Preventing Invasive Fungal Infections in Adult Patients With Newly Diagnosed Acute Myeloid Leukemia or Myelodysplastic Syndrome and Neutropenia

Inclusion Criteria:

* Patients with either newly diagnosed AML or MDS who have either begun (within 4 days of starting study drug) or are planned to begin specific treatment for their AML/MDS; hydroxyurea and cytarabine used for cytoreduction while awaiting initiation of definitive therapy are not considered "specific" treatment; patients who are participating in other therapeutic clinical trials for their AML/MDS may participate in this trial
* Patients must have or be anticipated to have neutropenia (absolute neutrophil count \[ANC\] \< 0.5 x 10\^9/L) (75) for \>= 7 days as a result of treatment of their AML/MDS
* Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2
* Total bilirubin =\< 3 x upper limit of normal (ULN)
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 5 x ULN
* Patients must be able to take oral medications, although a brief period of IV therapy (\< 4 days) is permitted at trial entry
* Patients must be willing and able to provide written informed consent for the trial
* Women of childbearing potential (WOCBP) must practice 2 effective methods of birth control during the course of the study; male patients who are partners of WOCBP should also practice an effective method of contraception; effective methods of birth control include diaphragm or condoms with spermicidal foam or jelly, birth control pills (BCPs), injections or patches, intra-uterine devices (IUDs) and surgical sterilization
* Postmenopausal women must be amenorrheic for \>= 12 months to be considered of non-childbearing potential
* Women and men must continue birth control for the duration of the trial and \>= 3 months after the last dose of study drug
* All WOCBP MUST have a negative pregnancy test prior to first receiving study medication

Exclusion Criteria:

* Proven, probable or possible IFI within the previous 30 days
* Use of any systemic antifungal therapy for \> 72 hours during the week prior to study drug initiation
* History of hypersensitivity or idiosyncratic reactions to azoles
* Patients with familial short QT syndrome or with corrected QT (QTc) interval =\< 300 ms
* Patients on strong CYP3A4 inducers or inhibitors that cannot be discontinued
* Women who are pregnant or nursing, or intend to be/do so during the course of the study
* Patients with severe hepatic impairment (Child-Pugh class C)
* Patients with known or suspected Gilbert's syndrome at the time of study enrollment
* Patients with known gastrointestinal conditions that could potentially interfere with absorption of orally administered medications
* Any condition that, in the opinion of the investigator, may interfere with the objectives of the study, e.g., any condition requiring the use of prohibited drugs or unstable medical conditions other than AML/MDS, such as a cardiac or neurologic disorder expected to be unstable or progressive during the course of the study (e.g., seizures or demyelinating syndromes, acute myocardial infarction within 3 months of study entry, myocardial ischemia or unstable congestive heart failure, unstable arrhythmias)