Efficacy of micafungin in treating four premature infants with candidiasis.
BACKGROUND
Although clinical experience in neonates with candidiasis exists for amphotericin B and fluconazole, these standard treatments are often hindered by drug-associated toxicity or development of resistant strains. The aim of the present study was therefore to investigate the efficacy and tolerability of a new antifungal agent, micafungin (MCFG), for treating Candida infections in premature infants.


METHODS
This was a retrospective cohort study. Premature infants diagnosed with Candida infections from October 2003 to July 2004 were brought to the neonatal intensive care unit at the Center of Perinatal Medicine, Nara Medical University Hospital. Four newborns were given 0.5-1.0 mg/kg per day micafungin.


RESULTS
Four premature infants (mean +/- SD gestational age, 24.1 +/- 0.9 weeks; mean +/- SD birthweight, 579.3 +/- 80.5 g) experienced complications from Candida infection; two cases of the fungal infection were caused by Candida glabrata and two cases were caused by Candida albicans. MCFG was administered at 0.5 or 1.0 mg/kg per day (mean dosage days, 9.8 +/- 3.1 days) and it decreased beta-D-glucan levels while improving clinical symptoms in all cases. Additionally, there were no apparent side-effects.


CONCLUSIONS
MCFG is both effective and tolerable for use in premature infants suffering from Candida infections.
Kawaguchi
Chiharu
C
Division of Neonatal Intensive Care, Perinatal Center, Nara Medical Hospital University Hosptial, Kashihara, Japan.
Arai
Ikuyo
I
Yasuhara
Hajime
H
Sano
Reiko
R
Nishikubo
Toshiya
T
Takahashi
Yukihiro
Y
D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000097:blood / Q000188:drug therapy*; D054714:Echinocandins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D055666:Lipopeptides / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D012189:Retrospective Studies; D016896:Treatment Outcome; D047071:beta-Glucans / Q000097:blood
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D047071:beta-Glucans; D000077551:Micafungin