title: Micafungin as empirical antifungal therapy in hematological patients: a retrospective, multicenter study in the Czech and Slovak Republics.
abstract: The objective of this retrospective, multicenter study was to evaluate the efficacy and safety of micafungin as empirical antifungal therapy during febrile neutropenia (FN) in 73 hematological patients from six centers in two countries. All patients received 100 mg of micafungin/day. The overall favorable response rate (RR) was 64.8% when the resolution of fever during neutropenia was included in the response criteria and 84.5% when excluded. A significantly lower favorable RR in patients with persistent fever and non-specific pulmonary infiltrates compared to patients with persistent fever only (82.8 vs. 52.4%, respectively; p = 0.011) was not found when resolution of fever was not included in the composite endpoint criteria (93.1 vs. 78.6%, respectively; p = 0.180). Breakthrough fungal disease developed in 2.7% of patients. Treatment was discontinued in 16.4% of cases. Only one patient (1.4%) discontinued therapy due to an adverse event. Posaconazole prophylaxis improved favorable RR when defervescence was included as composite endpoint criterion (p = 0.047), but not when it was excluded (p = 0.485). However, neutrophil recovery did not influence favorable RR (p = 0.803 and p = 0.112, respectively). These data suggest that micafungin is safe and effective as an empirical therapy in patients with FN.
authors.affiliation: Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic. zracil@fnbrno.cz
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Racil
authors.forename: Martina
authors.initials: M
authors.lastname: Toskova
authors.forename: Iva
authors.initials: I
authors.lastname: Kocmanova
authors.forename: Lucie
authors.initials: L
authors.lastname: Buresova
authors.forename: Michal
authors.initials: M
authors.lastname: Kouba
authors.forename: Lubos
authors.initials: L
authors.lastname: Drgona
authors.forename: Lucia
authors.initials: L
authors.lastname: Masarova
authors.forename: Tomas
authors.initials: T
authors.lastname: Guman
authors.forename: Elena
authors.initials: E
authors.lastname: Tothova
authors.forename: Julia
authors.initials: J
authors.lastname: Gabzdilova
authors.forename: Kristina
authors.initials: K
authors.lastname: Forsterova
authors.forename: Jan
authors.initials: J
authors.lastname: Haber
authors.forename: Barbora
authors.initials: B
authors.lastname: Ziakova
authors.forename: Eva
authors.initials: E
authors.lastname: Bojtarova
authors.forename: Monika
authors.initials: M
authors.lastname: Rolencova
authors.forename: Shira
authors.initials: S
authors.lastname: Timilsina
authors.forename: Petr
authors.initials: P
authors.lastname: Cetkovsky
authors.forename: Jiri
authors.initials: J
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D018153:Czech Republic; D054714:Echinocandins / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D055666:Lipopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy*; D012189:Retrospective Studies; D018154:Slovakia; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin