Micafungin versus fluconazole for prophylaxis against fungal infections in premature infants

Related Experiment Video

Updated: May 10, 2026

Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds
08:54

Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds

Published on: February 14, 2018

Yoshinobu Maede1, Satoshi Ibara, Hiraku Nagasaki

  • 1Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|June 19, 2013
PubMed
Abstract

Insights

Micafungin (MCFG) demonstrated superior efficacy compared to fluconazole (FLCZ) in preventing fungal infections in extremely low-birthweight infants. This study highlights MCFG as a more effective prophylactic agent for this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Extremely low-birthweight infants (<1000g, <26 weeks gestational age) are highly susceptible to fungal infections.
  • Prophylaxis against invasive fungal infections is critical in this vulnerable neonatal population.
  • Comparative efficacy of antifungal agents for prophylaxis requires further investigation.

Purpose of the Study:

  • To compare the prophylactic effects of micafungin (MCFG) and fluconazole (FLCZ) against fungal infections.
  • To evaluate the incidence of fungal infections in extremely low-birthweight infants receiving either MCFG or FLCZ prophylaxis.

Main Methods:

  • A comparative clinical study was conducted.
  • Infants received enteral miconazole plus intravenous FLCZ (5 mg/kg/day) or intravenous MCFG (3 mg/kg/day).
  • Prophylaxis failure was defined as fungal infection within 21 days of birth.

Main Results:

  • The success rate of prophylaxis was significantly higher in the MCFG group (71%) compared to the FLCZ group (39%).
  • MCFG prophylaxis was successful in 15 of 21 infants, while FLCZ was successful in 7 of 18 infants.
  • These findings indicate a notable difference in the effectiveness of the two antifungal agents.

Conclusions:

  • Micafungin (MCFG) is superior to fluconazole (FLCZ) for fungal infection prophylaxis in extremely low-birthweight infants.
  • MCFG represents a more effective strategy for preventing invasive fungal infections in this high-risk neonatal group.
  • The study supports the use of MCFG for enhanced antifungal protection in preterm neonates.
Keywords:
extremely low-birthweight infantsfluconazolefungal infectionsmicafunginmiconazoleprophylaxis

More Related Videos

Generation of Fluorescent Protein Fusions in Candida Species09:27

Generation of Fluorescent Protein Fusions in Candida Species

Published on: March 4, 2017

Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus12:29

Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus

Published on: April 19, 2017

Related Concept Videos

Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions01:15

Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions

PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure (CHF).
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Fungal Phylum Microsporidia01:28

Fungal Phylum Microsporidia

Microsporidia are a group of obligate intracellular fungi that were initially classified as protists but were later reclassified based on phylogenetic, molecular, and structural evidence linking them to the Chytridiomycota. These unicellular, non-motile organisms are highly specialized parasites that infect a wide range of animal hosts, including humans. They have evolved extensive genomic and metabolic reductions, making them highly dependent on their hosts for survival.Morphology and Genomic...
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...