title: Antifungal prophylaxis with micafungin in patients treated for childhood cancer.
abstract: 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.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kusuki
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Hashii
authors.forename: Hisao
authors.initials: H
authors.lastname: Yoshida
authors.forename: Sachiko
authors.initials: S
authors.lastname: Takizawa
authors.forename: Emiko
authors.initials: E
authors.lastname: Sato
authors.forename: Sadao
authors.initials: S
authors.lastname: Tokimasa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohta
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents; D054714:Echinocandins; D055666:Lipopeptides; D047071:beta-Glucans; D000077551:Micafungin