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Micafungin.

Peggy L Carver1

  • 1College of Pharmacy, University of Michigan, 428 Church St., Ann Arbor, MI 48109-1065, USA. peg@umich.edu

The Annals of Pharmacotherapy
|September 2, 2004
PubMed
Summary

Micafungin, an echinocandin antifungal, shows efficacy against Candida and Aspergillus species, including resistant strains. It is effective for esophageal candidiasis and as prophylaxis in stem-cell transplant patients, with mild adverse events.

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Area of Science:

  • Mycology
  • Pharmacology
  • Infectious Diseases

Background:

  • Micafungin is an echinocandin antifungal agent.
  • Echinocandins target the fungal cell wall synthesis pathway.

Purpose of the Study:

  • To review the pharmacology, mycology, chemistry, in vitro susceptibility, pharmacokinetics, clinical efficacy, safety, tolerability, dosage, and administration of micafungin.
  • To summarize the clinical efficacy and safety of micafungin based on available studies.

Main Methods:

  • A comprehensive MEDLINE search was conducted from 1978 to November 2003.
  • Supplementary data included conference abstracts and manufacturer information.
  • In vitro, preclinical, and clinical (Phase II and III) studies were evaluated.

Main Results:

  • Micafungin exhibits in vitro activity against various yeasts and molds, including azole-resistant Candida species.
  • Parenteral administration of micafungin has demonstrated efficacy in treating esophageal candidiasis in HIV-infected patients.
  • Comparative trials show micafungin is effective for antifungal prophylaxis in hematopoietic stem-cell transplant recipients, with generally mild adverse events like hyperbilirubinemia.

Conclusions:

  • Micafungin is active against Aspergillus spp. and Candida spp., including azole-resistant strains.
  • It is effective for esophageal candidiasis and superior to fluconazole for prophylaxis in stem-cell transplant patients.
  • Further clinical trials are needed to establish micafungin's role in other fungal infections.

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