[Micafungin for therapy of invasive candidiasis in solid organ transplant recipients].
BACKGROUND
Micafungin is an echinocandin approved for the prevention of Candida spp. infection in hematopoietic stem cell transplantation and therapy of oesophageal candidiasis, disseminated candidiasis and candidemia in adults, children and neonates.


OBJECTIVE
To evaluate the role of micafungin for candidiasis therapy in solid organ transplant recipients.


METHODS
A medical literature review according to micafungin role for candidiasis therapy in transplant patients is performed.


RESULTS
Micafungin has shown fungicide activity against Candida species, including strains resistant or poorly susceptible to fluconazole. No dose adjustment is required when micafungin is administered in combination with other drugs used in transplant patients, excluding sirolimus, nifedipine and itraconazol. With these drugs, a minimal dose reduction is recommended. The results observed in transplant patients included in clinical trials are favourable and similar to results obtained in other kind of patients.


CONCLUSIONS
The clinical results, its safety profile and the low grade of medical interactions permit micafungin to be considered for therapy in specific groups of transplant patients.
Fortún-Abete
Jesús
J
Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España. fortun@ono.com
D000328:Adult; D000935:Antifungal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy*; D002648:Child; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016469:Fungemia / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D055666:Lipopeptides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077551:Micafungin; D016377:Organ Transplantation; D011183:Postoperative Complications / Q000188:drug therapy*
D000935:Antifungal Agents; D054714:Echinocandins; D007166:Immunosuppressive Agents; D055666:Lipopeptides; D003577:Cytochrome P-450 Enzyme System; C104464:CYP3A protein, human; D051544:Cytochrome P-450 CYP3A; D000077551:Micafungin