[Clinical use of micafungin for the treatment of invasive candidiasis in critical ill patients].
BACKGROUND
Over the last 30 years a significant increase of Candida spp. invasive disease has been observed in non-neutropenic critical ill patients. Both fluconazole and amphotericin B have been considered first line treatment for invasive (proven and probable) Candida spp. disease, although the mortality rate is still high.


OBJECTIVE
To review the current data on the use of micafungin for the treatment of Candida invasive disease in critical ill patients.


METHODS
The pharmacologic, mycological and clinical properties of micafungin are reviewed based on current published data. The use and efficacy of micafungin for the treatment of Candida invasive disease in critical ill patients is discussed.


CONCLUSIONS
To reduce the rate of mortality more effective antifungals and pre-emptive treatment strategies are currently warranted. Candins achieve better results for the treatment of invasive Candida disease in non-neutropenic critical ill patients. Micafungin has a good safety profile (similar to fluconazole). Micafungin is a first line drug for the treatment of invasive Candida disease and may be used as a pre- emptive approach followed by a de-escalating strategy with azoles.
Pozo-Laderas
Juan Carlos
JC
Servicio de Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, España. juancarlos.pozo@ono.com
D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy* / Q000453:epidemiology; D000077336:Caspofungin; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003422:Critical Care; D016638:Critical Illness; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016469:Fungemia / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D055666:Lipopeptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077551:Micafungin; D009504:Neutrophils; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin; D000077551:Micafungin