title: The management of Candida infections in preterm neonates and the role of micafungin.
abstract: The burden of neonatal invasive Candida infection (ICI) has been increasing recently and identification of effective preventative and treatment strategies is a priority. In this view, the echinocandin class of antifungal agents has emerged as a suitable and promising option for treatment. These agents have overall characteristics that suitably meet the needs of neonatal patients, such as coverage against biofilms and against fluconazole-resistant strains of Candida spp, which is an issue in an epoch of increasing prophylactic use of fluconazole in the nursery. Micafungin is the only echinocandin authorized for neonatal use by the EMA, based on efficacy and PK data from neonatal populations. Although the kinetics and appropriate dosing of this agent in premature and term infants have been described in the recent years, through either neonatal studies or extrapolation form adult data, further studies are needed to better address this area. These studies should be properly designed for neonatal populations, and must better address long-term safety and the clinical outcomes related to echinocandin use in neonates.
authors.affiliation: Neonatology and NICU, S. Anna Hospital, Torino, Italy. paolomanzoni@hotmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Manzoni
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Benjamin
authors.forename: William
authors.initials: W
authors.lastname: Hope
authors.forename: Stefano
authors.initials: S
authors.lastname: Rizzollo
authors.forename: Paola
authors.initials: P
authors.lastname: Del Sordo
authors.forename: Mauro
authors.initials: M
authors.lastname: Stronati
authors.forename: Evelyne
authors.initials: E
authors.lastname: Jacqz-Aigrain
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Daniele
authors.initials: D
authors.lastname: Farina
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy* / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D054714:Echinocandins / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D055666:Lipopeptides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077551:Micafungin
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin