Efficacy and safety of micafungin as an empirical antifungal agent for febrile neutropenic patients with hematological diseases.
BACKGROUND
This observational study was conducted to document the efficacy and safety of the use of micafungin (Mycamine) as an empirical antifungal agent in febrile neutropenic patients.


METHODS
Micafungin was administered for sustained fever (>38.4°C) on days 3-5 following the initiation of empirical antibiotic therapy. The overall success rate and side effects were evaluated.


RESULTS
A total of 47 patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome and lymphoma were enrolled in the study. The overall success rate of micafungin was 61.7% (29/47). A total of 3 patients (6.4%) experienced grade 3/4 elevations in their aspartate aminotransferase levels, and 10 patients (21%) experienced grade 3/4 hyperbilirubinemia, 9 of which resolved. Four patients died of septic shock. Younger patients (<50 years) and patients with acute lymphoblastic leukemia exhibited a better response to micafungin than other patients. Patients that were less profoundly neutropenic (≥0.05 × 10(9)/l) also had a better response to micafungin, as did the patients who recovered from their fever or neutropenia.


CONCLUSIONS
Micafungin has an excellent efficacy (61.7%) and safety profile when used as an empirical antifungal agent in febrile neutropenic patients with hematological disorders.
Park
Joon Seong
JS
Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
Kim
Dong Hwan
DH
Choi
Chul Won
CW
Jeong
Seong Hyun
SH
Choi
Jin-Hyuk
JH
Kim
Kihyun
K
Kim
Seok Jin
SJ
Jung
Chul Won
CW
Yang
Deok-Hwan
DH
Jang
Jun Ho
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D054714:Echinocandins / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000276:immunology; D055666:Lipopeptides / Q000008:administration & dosage* / Q000009:adverse effects; D008223:Lymphoma / Q000150:complications / Q000276:immunology; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000276:immunology; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000276:immunology; D009503:Neutropenia / Q000150:complications* / Q000276:immunology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000276:immunology; D011446:Prospective Studies; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin