BACKGROUND: Invasive fungal infections (IFIs) remain a major cause of infectious morality in neutropenic patients receiving chemotherapy or hematopoietic stem cell transplantation (HSCT). Micafungin exhibits broad antifungal activity against both Aspergillus and Candida species. We performed a retrospective study to determine the efficacy and safety of prophylactic micafungin against IFI in pediatric neutropenic patients during chemotherapy or HSCT. PROCEDURE: Forty patients were given micafungin (3 mg/kg/day) intravenously for neutropenia: 131 patient-cycles (39 patients) after chemotherapy and 15 patient-cycles (14 patients) after HSCT. Median duration of neutropenia and micafungin prophylaxis was 13 and 23 days after chemotherapy and HSCT, respectively. RESULTS: Treatment success rate, defined as absence of proven, probable, possible, or suspected IFIs, was 93.9% (121/131) and 80.0% (12/15) for chemotherapy and HSCT, respectively. Proven or probable IFI was documented in only one patient after HSCT. No adverse events were observed that could be related to micafungin prophylaxis. CONCLUSIONS: These results suggest that prophylactic micafungin is well tolerated and may prevent IFIs in pediatric patients with neutropenia receiving chemotherapy or HSCT.
BACKGROUND: Invasive fungal infections (IFIs) remain a major cause of infectious morality in neutropenicpatients receiving chemotherapy or hematopoietic stem cell transplantation (HSCT). Micafungin exhibits broad antifungal activity against both Aspergillus and Candida species. We performed a retrospective study to determine the efficacy and safety of prophylactic micafungin against IFI in pediatric neutropenicpatients during chemotherapy or HSCT. PROCEDURE: Forty patients were given micafungin (3 mg/kg/day) intravenously for neutropenia: 131 patient-cycles (39 patients) after chemotherapy and 15 patient-cycles (14 patients) after HSCT. Median duration of neutropenia and micafungin prophylaxis was 13 and 23 days after chemotherapy and HSCT, respectively. RESULTS: Treatment success rate, defined as absence of proven, probable, possible, or suspected IFIs, was 93.9% (121/131) and 80.0% (12/15) for chemotherapy and HSCT, respectively. Proven or probable IFI was documented in only one patient after HSCT. No adverse events were observed that could be related to micafungin prophylaxis. CONCLUSIONS: These results suggest that prophylactic micafungin is well tolerated and may prevent IFIs in pediatric patients with neutropenia receiving chemotherapy or HSCT.
Authors: K Yoshikawa; Y Nakazawa; Y Katsuyama; K Hirabayashi; S Saito; T Shigemura; M Tanaka; R Yanagisawa; K Sakashita; K Koike Journal: Infection Date: 2014-02-25 Impact factor: 3.553
Authors: H J Park; M Park; M Han; B H Nam; K N Koh; H J Im; J W Lee; N-G Chung; B Cho; H-K Kim; K H Yoo; H H Koo; H J Kang; H Y Shin; H S Ahn; Y T Lim; H Kook; C J Lyu; J O Hah; J E Park; Y J Lim; J J Seo Journal: Bone Marrow Transplant Date: 2014-07-07 Impact factor: 5.483