Micafungin: pharmacology, experimental therapeutics and clinical applications.
Invasive fungal infections are important causes of morbidity and mortality in hospitalised patients. Current therapy with amphotericin B and antifungal triazoles has overlapping targets and is limited by toxicity and resistance. Echinocandins are a new class of antifungal drugs, which inhibit the synthesis of 1,3-beta-D-glucan. This homopolysaccharide is an important component of the cell wall of many pathogenic fungi, providing osmotic stability and functioning in cell growth and cell division. Micafungin, which is a member of the echinocandin class, exhibits in vitro fungicidal or fungistatic activity against a variety of fungal pathogens which include Candida and Aspergillus species but not Cryptococcus, Fusarium or Zygomycetes. Micafungin demonstrates linear pharmacokinetics, which are not altered by drugs metabolised through the P450 enzyme system. The preclinical and clinical data strongly support the development of micafungin for treatment of proven or suspected mucosal and invasive Candida infections in immunocompetent and immunocompromised patients. This paper reviews the preclinical and clinical pharmacology of micafungin and its potential role for treatment of fungal invasive infections in patients.
Groll
Andreas H
AH
Pediatric Oncology Branch, National Cancer Institute, Building 10, Room 1-3888, National Institutes of Health, Bethesda, MD 20892, USA.
Stergiopoulou
Theodouli
T
Roilides
Emmanuel
E
Walsh
Thomas J
TJ
D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy; D001230:Aspergillus / Q000187:drug effects / Q000254:growth & development; D002175:Candida / Q000187:drug effects / Q000254:growth & development; D002177:Candidiasis / Q000188:drug therapy; D004195:Disease Models, Animal; D054714:Echinocandins; D006801:Humans; D055666:Lipopeptides; D008074:Lipoproteins / Q000494:pharmacology* / Q000627:therapeutic use*; D000077551:Micafungin; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy*; D010456:Peptides, Cyclic / Q000494:pharmacology* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D000077551:Micafungin