title: Intraocular penetration of micafungin in patient with Candida albicans endophthalmitis.
abstract: OBJECTIVE
  To investigate the penetration of micafungin, a new class of echinocandin antifungal agent, into the aqueous humor and vitreous after an intravenous administration.
  
  
  METHODS
  Endogenous endophthalmitis caused by Candida albicans developed bilaterally in a 67-year-old man. Three hours before vitrectomy, the patient received an intravenous injection of 300 mg micafungin. Samples of aqueous and vitreous were collected during the vitrectomy approximately 60 min after the intravenous injection. The concentration of micafungin in both bodies was determined by high-performance liquid chromatography.
  
  
  RESULTS
  The concentration of micafungin was 25.36 μg/mL in the serum, 0.026 μg/mL in the aqueous, and 0.043 μg/mL in the vitreous. The micafungin minimum inhibitory concentration (MIC) against the C. albicans strain isolated from our patient was 0.03 μg/mL. Thus, the micafungin reached the MIC in the vitreous.
  
  
  CONCLUSIONS
  We suggest that intravenous micafungin should be considered in mild cases of endogenous fungal endophthalmitis, or be given in combination with other intravitreal antifungal agents with vitrectomy in more severe cases.
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan. mochi-gif@umin.ac.jp
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Suemori
authors.forename: Kazunari
authors.initials: K
authors.lastname: Udo
authors.forename: Shinya
authors.initials: S
authors.lastname: Komori
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yamada
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogura
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001082:Aqueous Humor / Q000378:metabolism; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology; D002851:Chromatography, High Pressure Liquid; D054714:Echinocandins / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007275:Injections, Intravenous; D055666:Lipopeptides / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D008826:Microbial Sensitivity Tests; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin