Efficacy and Safety of Micafungin as an Empirical Antifungal Agent for Febrile Neutropenic Patients with Hematological Diseases

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 × 109/l) also had a better response to micafungin, as did the patients who recovered from their fever or neutropenia. Conclusion: Micafungin has an excellent efficacy (61.7%) and safety profile when used as an empirical antifungal agent in febrile neutropenic patients with hematological disorders.

• Publication year

  2010

• Venue

  Acta Haematologica

• Publication date

  2010-07-21

• Fields of study

  Medicine

• Identifiers
  DOI 10.1159/000315558PMID 20664196
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Efficacy and safety of micafungin, an echinocandin antifungal agent, on invasive fungal infections in patients with hematological disorders

  2009cited by this paper
• Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

  2008influential reference
• Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis.

  2007cited by this paper
• Risks, diagnosis and outcomes of invasive fungal infections in haematopoietic stem cell transplant recipients

  2007cited by this paper
• Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial.

  2007cited by this paper
• Epidemiology, Outcomes, and Costs of Invasive Aspergillosis in Immunocompromised Children in the United States, 2000

  2006cited by this paper
• International, open-label, noncomparative, clinical trial of micafungin alone and in combination for treatment of newly diagnosed and refractory candidemia

  2005cited by this paper
• A Multicenter, Open-Label Clinical Study of Micafungin (FK463) in the Treatment of Deep-seated Mycosis in Japan

  2004cited by this paper
• Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia.

  2004cited by this paper
• Bioinformatics research on inter-racial difference in drug metabolism I. Analysis on frequencies of mutant alleles and poor metabolizers on CYP2D6 and CYP2C19.

  2003cited by this paper
• Antifungal Susceptibility Survey of 2,000 Bloodstream Candida Isolates in the United States

  2003cited by this paper
• Antifungal mechanism of FK463 against Candida albicans and Aspergillus fumigatus.

  2002cited by this paper
• Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever.

  2002cited by this paper
• Intravenous and Oral Itraconazole versus Intravenous Amphotericin B Deoxycholate as Empirical Antifungal Therapy for Persistent Fever in Neutropenic Patients with Cancer Who Are Receiving Broad-Spectrum Antibacterial Therapy

  2001cited by this paper
• A multicenter, randomized trial of fluconazole versus amphotericin B for empiric antifungal therapy of febrile neutropenic patients with cancer.

  2000cited by this paper
• In Vitro Activities of a New Lipopeptide Antifungal Agent, FK463, against a Variety of Clinically Important Fungi

  2000cited by this paper
• Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. National Institute of Allergy and Infectious Diseases Mycoses Study Group.

  1999cited by this paper
• Liposomal Amphotericin B for Empirical Therapy in Patients with Persistent Fever and Neutropenia

  1999cited by this paper
• Emerging fungal pathogens in immunocompromised patients: classification, diagnosis, and management.

  1993cited by this paper
• Infections with Aspergillus species.

  1993cited by this paper
• Nosocomial pneumonia in patients having bone marrow transplant attributable mortality and risk factors

  1992cited by this paper
• Empiric antifungal therapy in febrile granulocytopenic patients. EORTC International Antimicrobial Therapy Cooperative Group.

  1989cited by this paper
• The value of protective isolation in preventing nosocomial infections in high risk patients.

  1981cited by this paper

• Bridging antifungal prophylaxis with micafungin in hematopoietic stem cell transplantation: a retrospective analysis

  2021cites this paper
• Efficacy and safety of micafungin in empiric and D-index-guided early antifungal therapy for febrile neutropenia; A subgroup analysis of the CEDMIC trial.

  2020cites this paper
• Effectiveness and Safety of Micafungin in Managing Invasive Fungal Infections among Patients in Greece with Hematologic Disorders: The ASPIRE Study

  2019cites this paper
• Efficacy and safety of micafungin versus extensive azoles in the prevention and treatment of invasive fungal infections for neutropenia patients with hematological malignancies: A meta-analysis of randomized controlled trials

  2017cites this paper
• Newer antifungal agents micafungin and voriconazole for fungal infection prevention during hematopoietic cell transplantation: a meta-analysis.

  2016cites this paper
• Invasive Aspergillosis in Hematological Patients.

  2016cites this paper
• Efficacy and safety of micafungin versus intravenous itraconazole as empirical antifungal therapy for febrile neutropenic patients with hematological malignancies: a randomized, controlled, prospective, multicenter study

  2015cites this paper
• [Patients treated with micafungin during their stay in intensive care unit].

  2015cites this paper
• Micafungina en pacientes críticos ingresados en unidad de cuidados intensivos

  2015influential citation
• [Recommendations for the management of candidemia in adults in Latin America. Grupo Proyecto Épico].

  2013cites this paper
• Efficacy and Safety of Micafungin for Febrile Neutropenia in Pediatric Patients With Hematological Malignancies: A Multicenter Prospective Study

  2013cites this paper
• Recommendations for the management of candidemia in adults in Latin America. Latin America Invasive Mycosis Network.

  2013cites this paper
• ecommendations for the management of candidemia in adults in Latin America

  2013cites this paper
• Micafungin for empirical antifungal therapy in patients with febrile neutropenia: multicenter phase 2 study

  2013cites this paper
• Safety of micafungin in prospective and retrospective clinical trials

  2012cites this paper
• Efficacy and safety of micafungin as an empirical antifungal therapy for suspected fungal infection in neutropenic patients with hematological disorders

  2012cites this paper
• Micafungin in haematology

  2012cites this paper
• Candida albicans induces monocyte training via epigenetic reprogramming through a dectin-1-dependent pathway

  2012cites this paper
• Retrospective Survey on the Prevalence and Outcome of Prior Autoimmune Diseases in Patients with Aplastic Anemia Reported to the Registry of the European Group for Blood and Marrow Transplantation

  2010cites this paper