Efficacy and safety of micafungin, an echinocandin antifungal agent, on invasive fungal infections in patients with hematological disorders.
The study was conducted as a prospective multicenter trial to evaluate the efficacy and safety of micafungin in patients with invasive fungal infections (IFIs) in hematological disorders. A total of 277 patients was registered, and 197 were assessed for clinical efficacy. The mean dosage and duration of micafungin were 170.7 mg/day and 22.0 days, respectively. The efficacy rates were 87.5% (7/8) for patients with candidiasis, 44.7% (17/38) for probable IFIs, 61.9% (39/63) for possible IFIs and 80.7% (71/88) for those who failed to respond to antibacterials. In patients with febrile neutropenia (below 500 microL), despite broad-spectrum antibacterial treatment over 2 days, 86.3% (44/51) of patients had a favourable response to micafungin. The incidence of adverse events related to micafungin was 14.1% (39/277), but most of them were mild and reversible. These data indicate the usefulness of micafungin as a novel therapeutic drug for both empirical and targeted therapy for IFIs.
Tamura
Kazuo
K
Department of Internal Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan. ktamura@fukuoka-u.ac.jp
Urabe
Akio
A
Yoshida
Minoru
M
Kanamaru
Akihisa
A
Kodera
Yoshihisa
Y
Okamoto
Shinichiro
S
Maesaki
Shigefumi
S
Masaoka
Tohru
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D054714:Echinocandins / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D055666:Lipopeptides / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D009181:Mycoses / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D009504:Neutrophils / Q000166:cytology / Q000187:drug effects
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin