[Comparison of micafungin and fosfluconazole as prophylaxis for invasive fungal infection during neutropenia in children undergoing chemotherapy and hematopoietic stem cell transplantation].
Invasive fungal infection (IFI) is a serious complication of chemotherapy for hematological malignancies and autologous/allogeneic hematopoietic stem cell transplantation in children and shows a high mortality rate. We performed a randomized trial comparing micafungin (MCFG), a new anti-fungal agent, with fosfluconazole, a prodrug of fluconazole (FF) conventionally used as a prophylactic agent, for prophylaxis against IFI. Cefpirome was administered as prophylaxis against bacterial infection, and meropenem+minocycline as an empiric window therapy for febrile neutropenia. MCFG 2 mg/kg/day (max 100 mg/day) and FF 10 mg/kg/day (max 400 mg/day) were both safe and effective (event free ratio of IFI, MCFG 94.4% vs FF 94.3%) without significant difference. Thus, MCFG is safe and can be used for prophylaxis against IFI in children.
Sawada
Akihisa
A
Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health.
Sakata
Naoki
N
Higuchi
Banryoku
B
Takeshita
Yasufumi
Y
Ishihara
Takashi
T
Sakata
Akifumi
A
Kouroki
Masahiko
M
Kondo
Osamu
O
Koyama
Maho
M
Hirano
Shinya
S
Yasui
Masahiro
M
Inoue
Masami
M
Yoshioka
Akira
A
Kawa
Keisei
K
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage*; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D055666:Lipopeptides / Q000008:administration & dosage*; D008297:Male; D000077731:Meropenem; D000077551:Micafungin; D008911:Minocycline / Q000008:administration & dosage; D009181:Mycoses / Q000150:complications* / Q000517:prevention & control*; D009503:Neutropenia / Q000150:complications* / Q000628:therapy; D009894:Opportunistic Infections / Q000150:complications* / Q000517:prevention & control*; D010755:Organophosphates / Q000008:administration & dosage*; D011355:Prodrugs / Q000008:administration & dosage*; D013845:Thienamycins / Q000008:administration & dosage
D054714:Echinocandins; D055666:Lipopeptides; D010755:Organophosphates; D011355:Prodrugs; D013845:Thienamycins; C486878:fosfluconazole; D015725:Fluconazole; D000077731:Meropenem; D008911:Minocycline; D000077551:Micafungin