title: Efficacy and safety of micafungin as an empirical antifungal agent for febrile neutropenic patients with hematological diseases.
abstract: 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.
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Kim
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Seong Hyun
authors.initials: SH
authors.lastname: Jeong
authors.forename: Jin-Hyuk
authors.initials: JH
authors.lastname: Choi
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Jang
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin