Antifungal prophylaxis with micafungin in patients treated for childhood cancer.
BACKGROUND
Invasive fungal infections (IFIs) remain a major cause of infectious morality in neutropenic patients receiving chemotherapy or hematopoietic stem cell transplantation (HSCT). Micafungin exhibits broad antifungal activity against both Aspergillus and Candida species. We performed a retrospective study to determine the efficacy and safety of prophylactic micafungin against IFI in pediatric neutropenic patients during chemotherapy or HSCT.


METHODS
Forty patients were given micafungin (3 mg/kg/day) intravenously for neutropenia: 131 patient-cycles (39 patients) after chemotherapy and 15 patient-cycles (14 patients) after HSCT. Median duration of neutropenia and micafungin prophylaxis was 13 and 23 days after chemotherapy and HSCT, respectively.


RESULTS
Treatment success rate, defined as absence of proven, probable, possible, or suspected IFIs, was 93.9% (121/131) and 80.0% (12/15) for chemotherapy and HSCT, respectively. Proven or probable IFI was documented in only one patient after HSCT. No adverse events were observed that could be related to micafungin prophylaxis.


CONCLUSIONS
These results suggest that prophylactic micafungin is well tolerated and may prevent IFIs in pediatric patients with neutropenia receiving chemotherapy or HSCT.
Kusuki
Shigenori
S
Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.
Hashii
Yoshiko
Y
Yoshida
Hisao
H
Takizawa
Sachiko
S
Sato
Emiko
E
Tokimasa
Sadao
S
Ohta
Hideaki
H
Ozono
Keiichi
K
D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D054714:Echinocandins / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007223:Infant; D055666:Lipopeptides / Q000627:therapeutic use*; D000077551:Micafungin; D009181:Mycoses / Q000517:prevention & control*; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D047071:beta-Glucans / Q000097:blood
D000935:Antifungal Agents; D000970:Antineoplastic Agents; D054714:Echinocandins; D055666:Lipopeptides; D047071:beta-Glucans; D000077551:Micafungin