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Safety of micafungin in infants: insights into optimal dosing

Simon Ascher1, Phillip Brian Smith, Daniel K Benjamin

  • 1Duke University, Department of Pediatrics, 2400 Pratt St., Durham, NC 27715, USA. danny.benjamin@duke.edu

Expert Opinion on Drug Safety
|January 14, 2011
PubMed
Abstract

Insights

Micafungin is a safe and effective treatment for invasive candidiasis in neonatal intensive care units (NICUs). A 10 mg/kg/day dose is recommended for both term and preterm infants, showing good tolerability.

Area of Science:

  • Neonatal Medicine
  • Pediatric Infectious Diseases
  • Pharmacology

Background:

  • Invasive Candida infections pose significant mortality risks in neonatal intensive care units (NICUs).
  • Micafungin presents a promising antifungal treatment option for infants, supported by its established safety in older populations.
  • Assessing micafungin safety is crucial for vulnerable premature infants with complex medical conditions.

Purpose of the Study:

  • To review existing literature on micafungin's safety profile in infants.
  • To provide dosing recommendations for treating invasive candidiasis in the NICU setting.

Main Methods:

  • A comprehensive Medline literature search was conducted up to September 2010.
  • Search terms included 'micafungin', 'safety', 'antifungal', 'candidiasis', 'drug toxicity', 'infant, premature', and 'infant, newborn'.
  • The review focused on studies evaluating micafungin's safety and efficacy in neonates.

Main Results:

  • Limited safety data are available for micafungin in the infant population.
  • Higher doses of micafungin demonstrated safety and good tolerability in the studied infants.

Conclusions:

  • Micafungin at a dose of 10 mg/kg/day is a viable option for invasive candidiasis in neonates.
  • This dosing regimen is recommended for both term and preterm infants in the NICU.
  • Further research is warranted to expand the safety data for micafungin in infants.

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