Micafungin in the treatment of invasive candidiasis and invasive aspergillosis

Micafungin is an echinocandin antifungal agent available for clinical use in Japan, Europe, and the United States. Through inhibition of β-1,3-glucan production, an essential component of the fungal cell wall, micafungin exhibits potent antifungal activity against key pathogenic fungi, including Candida and Aspergillus species, while contributing minimal toxicity to mammalian cells. This activity is maintained against polyene and azole-resistant isolates. Pharmacokinetic and pharmacodynamic studies have demonstrated linear kinetics both in adults and children with concentration-dependent activity observed both in vitro and in vivo. Dosage escalation studies have also demonstrated that doses much higher than those currently recommended may be administered without serious adverse effects. Clinically, micafungin has been shown to be efficacious for the treatment of invasive candidiasis and invasive aspergillosis. Furthermore, the clinical effectiveness of micafungin against these infections occurs without the drug interactions that occur with the azoles and the nephrotoxicity observed with amphotericin B formulations. This review will focus on the pharmacology, clinical microbiology, mechanisms of resistance, safety, and clinical efficacy of micafungin in the treatment of invasive candidiasis and invasive aspergillosis.

• Publication year

  2009

• Venue

  Infection and Drug Resistance

• Publication date

  2009-01-12

• Fields of study

  Medicine

• Identifiers
  DOI 10.2147/IDR.S3864PMID 21694882PMCID 3108724
• 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.

• Staphylococcus

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• Micafungin alone or in combination with other systemic antifungal therapies in hematopoietic stem cell transplant recipients with invasive aspergillosis

  2009cited by this paper
• Correlation of MIC with Outcome for Candida Species Tested against Caspofungin, Anidulafungin, and Micafungin: Analysis and Proposal for Interpretive MIC Breakpoints

  2008cited by this paper
• Efficacy of Single-Dose Liposomal Amphotericin B or Micafungin Prophylaxis in a Neutropenic Murine Model of Invasive Pulmonary Aspergillosis

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• Population pharmacokinetics of micafungin in adult patients.

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• Development of Caspofungin Resistance following Prolonged Therapy for Invasive Candidiasis Secondary to Candida glabrata Infection

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• Fungal infections in hematopoietic stem cell transplant recipients.

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• Use of a serum‐based antifungal susceptibility assay to predict the in vivo efficacy of novel echinocandin compounds

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• Micafungin Versus Liposomal Amphotericin B for Pediatric Patients With Invasive Candidiasis: Substudy of a Randomized Double-Blind Trial

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• Comparison of the dose-dependent activity and paradoxical effect of caspofungin and micafungin in a neutropenic murine model of invasive pulmonary aspergillosis.

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• Reduced Candida glabrata Susceptibility Secondary to an FKS1 Mutation Developed during Candidemia Treatment

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• Caspofungin-Resistant Candida tropicalis Strains Causing Breakthrough Fungemia in Patients at High Risk for Hematologic Malignancies

  2008influential reference
• Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: biological risk factors for infection according to time after transplantation.

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• Paradoxical Effect of Echinocandins across Candida Species In Vitro: Evidence for Echinocandin-Specific and Candida Species-Related Differences

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  2007cited by this paper
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  2007cited by this paper
• In Vivo Pharmacodynamic Characterization of Anidulafungin in a Neutropenic Murine Candidiasis Model

  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
• In Vivo Efficacy of Anidulafungin and Caspofungin against Candida glabrata and Association with In Vitro Potency in the Presence of Sera

  2007cited by this paper
• Serum Differentially Alters the Antifungal Properties of Echinocandin Drugs

  2007cited by this paper
• Comparative In Vitro Pharmacodynamics of Caspofungin, Micafungin, and Anidulafungin against Germinated and Nongerminated Aspergillus Conidia

  2007cited by this paper
• Anidulafungin versus fluconazole for invasive candidiasis.

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• Caspofungin modulates inflammatory responses to Aspergillus fumigatus through stage-specific effects on fungal beta-glucan exposure.

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• In Vitro Susceptibility of Invasive Isolates of Candida spp. to Anidulafungin, Caspofungin, and Micafungin: Six Years of Global Surveillance

  2007cited by this paper
• Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease.

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• Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem

  2007cited by this paper
• Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia.

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• Dectin-1 is required for beta-glucan recognition and control of fungal infection.

  2007cited by this paper
• Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis.

  2007cited by this paper
• Acquired Echinocandin Resistance in a Candida krusei Isolate Due to Modification of Glucan Synthase

  2007cited by this paper
• 46th Interscience Conference on Antimicrobial Agents and Chemotherapy.

  2007cited by this paper
• Emergence of a Candida krusei Isolate with Reduced Susceptibility to Caspofungin during Therapy

  2006cited by this paper
• Dectin-1: a signalling non-TLR pattern-recognition receptor

  2006cited by this paper
• In Vitro Pharmacodynamics of Anidulafungin and Caspofungin against Candida glabrata Isolates, Including Strains with Decreased Caspofungin Susceptibility

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• Progressive loss of echinocandin activity following prolonged use for treatment of Candida albicans oesophagitis.

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• Breakthrough trichosporonosis in patients with hematologic malignancies receiving micafungin.

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• Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis

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• Activities of Micafungin against 315 Invasive Clinical Isolates of Fluconazole-Resistant Candida spp

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• A study to determine the safety profile and maximum tolerated dose of micafungin (FK463) in patients undergoing haematopoietic stem cell transplantation

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• In Vitro Susceptibilities of Candida spp. to Caspofungin: Four Years of Global Surveillance

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• Once-Weekly Micafungin Therapy Is as Effective as Daily Therapy for Disseminated Candidiasis in Mice with Persistent Neutropenia

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• Steady-State Pharmacokinetics of Micafungin and Voriconazole after Separate and Concomitant Dosing in Healthy Adults

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• [Successful treatment by voliconazole for pulmonary and adductor magnus muscle aspergillosis induced by immunosuppressive therapy for hypersensitivity pneumonia].

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• Escape of Candida from Caspofungin Inhibition at Concentrations above the MIC (Paradoxical Effect) Accomplished by Increased Cell Wall Chitin; Evidence for β-1,6-Glucan Synthesis Inhibition by Caspofungin

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  2006influential reference
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• Emergence of disseminated candidiasis caused by Candida krusei during treatment with caspofungin: case report and review of literature.

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  2005influential reference
• Specific Substitutions in the Echinocandin Target Fks1p Account for Reduced Susceptibility of Rare Laboratory and Clinical Candida sp. Isolates

  2005cited by this paper
• Comparative Efficacies of Conventional Amphotericin B, Liposomal Amphotericin B (AmBisome), Caspofungin, Micafungin, and Voriconazole Alone and in Combination against Experimental Murine Central Nervous System Aspergillosis

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• Pharmacokinetic behavior of micafungin in rats with carbon tetrachloride-induced acute hepatic failure.

  2005cited by this paper
• Pharmacokinetics, Safety, and Tolerability of Caspofungin in Children and Adolescents

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• Pharmacokinetics of Micafungin in Healthy Volunteers, Volunteers With Moderate Liver Disease, and Volunteers With Renal Dysfunction

  2005influential reference
• Candida glabrata fungemia: experience in a tertiary care center.

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• Attenuation of the Activity of Caspofungin at High Concentrations against Candida albicans: Possible Role of Cell Wall Integrity and Calcineurin Pathways

  2005cited by this paper
• A randomized, double blind, comparative trial of micafungin (FK463) vs. fluconazole for the treatment of oesophageal candidiasis

  2005influential reference
• Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial.

  2005cited by this paper
• Pharmacokinetic and Maximum Tolerated Dose Study of Micafungin in Combination with Fluconazole versus Fluconazole Alone for Prophylaxis of Fungal Infections in Adult Patients Undergoing a Bone Marrow or Peripheral Stem Cell Transplant

  2005influential reference
• Concomitant Cyclosporine and Micafungin Pharmacokinetics in Healthy Volunteers

  2005influential reference
• International, open-label, noncomparative, clinical trial of micafungin alone and in combination for treatment of newly diagnosed and refractory candidemia

  2005influential reference
• Safety, Tolerability, and Pharmacokinetics of Micafungin (FK463) in Febrile Neutropenic Pediatric Patients

  2005influential reference
• Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation.

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  2004influential reference
• Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study.

  2004cited by this paper
• Pharmacokinetics and Safety of Intravenous Voriconazole in Children after Single- or Multiple-Dose Administration

  2004cited by this paper
• A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis.

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• Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants.

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• Paradoxical Effect of Caspofungin: Reduced Activity against Candida albicans at High Drug Concentrations

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• Interlaboratory Comparison of Results of Susceptibility Testing with Caspofungin against Candida and Aspergillus Species

  2004cited by this paper
• Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy.

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• Killing Activity of Micafungin against Aspergillus fumigatus Hyphae Assessed by Specific Fluorescent Staining for Cell Viability

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

  2003cited by this paper
• The echinocandin antifungals: an overview of the pharmacology, spectrum and clinical efficacy

  2003cited by this paper
• In vitro antifungal activities of anidulafungin and micafungin, licensed agents and the investigational triazole posaconazole as determined by NCCLS methods for 12,052 fungal isolates: review of the literature.

  2003influential reference
• In Vitro Antifungal Activity of Micafungin (FK463) against Dimorphic Fungi: Comparison of Yeast-Like and Mycelial Forms

  2003cited by this paper
• Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies

  2003cited by this paper
• Comparison of Two Methods and Three End Points in Determination of In Vitro Activity of Micafungin against Aspergillus spp

  2003influential reference
• From bloodjournal.hematologylibrary.org at PENN STATE UNIVERSITY on February 22, 2013. For personal use only.

  2002cited by this paper
• A randomized double-blind study of caspofungin versus fluconazole for the treatment of esophageal candidiasis.

  2002cited by this paper
• Dendritic Cells Transport Conidia and Hyphae of Aspergillus fumigatus from the Airways to the Draining Lymph Nodes and Initiate Disparate Th Responses to the Fungus1

  2002cited by this paper
• Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients.

  2002cited by this paper
• The epidemiology of Candida glabrata and Candida albicans fungemia in immunocompromised patients with cancer.

  2002cited by this paper
• Comparison of caspofungin and amphotericin B for invasive candidiasis.

  2002influential reference
• In Vitro Pharmacodynamic Properties of Three Antifungal Agents against Preformed Candida albicans Biofilms Determined by Time-Kill Studies

  2002cited by this paper
• Comparative Antifungal Activities and Plasma Pharmacokinetics of Micafungin (FK463) against Disseminated Candidiasis and Invasive Pulmonary Aspergillosis in Persistently Neutropenic Rabbits

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• Overexpression of Sbe2p, a Golgi Protein, Results in Resistance to Caspofungin in Saccharomyces cerevisiae

  2002cited by this paper
• Breakthrough trichosporonosis in a bone marrow transplant recipient receiving caspofungin acetate.

  2002cited by this paper
• In Vitro Activity of Micafungin (FK-463) against Candida spp.: Microdilution, Time-Kill, and Postantifungal-Effect Studies

  2002cited by this paper
• The Antifungal Echinocandin Caspofungin Acetate Kills Growing Cells of Aspergillus fumigatus In Vitro

  2002influential reference
• In Vitro Susceptibility Testing Methods for Caspofungin against Aspergillus andFusarium Isolates

  2001cited by this paper
• Aspergillosis case-fatality rate: systematic review of the literature.

  2001cited by this paper
• Glucan Synthase Complex of Aspergillus fumigatus

  2001cited by this paper
• Invasive mold infections in allogeneic bone marrow transplant recipients.

  2001cited by this paper

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