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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Micafungin may be safely administered as outpatient parenteral antimicrobial therapy for chronic pulmonary
Akaninyene A Otu1,2, Felix Bongomin2, Rohit Bazaz2
1Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
Background:
Intravenous micafungin has been reported as a treatment alternative in patients with chronic pulmonary aspergillosis (CPA) where long-term oral triazole therapy is unfeasible.
Objectives:
We evaluated the safety and efficacy of micafungin administered via the outpatient parenteral antimicrobial therapy (OPAT) service for the treatment of CPA.
Methods:
We included all CPA patients who received micafungin via OPAT between April 2016 and March 2018. Data on adverse events and line-related complications, and Quality of Life (QoL) scores at the start of micafungin course and 3 months later were extracted. Improvements in QoL were defined as an improvement of ≥4 points in at least one modality (symptom, impact, activity, total) in the St George's QoL score. A stable QoL score was defined as a change in score of <4 points in either direction whilst deterioration was defined as an increase of ≥4 points.
Results:
There were 20 OPAT episodes involving 18 patients with a median duration of micafungin therapy of 21 (range: 4-248) days. Improvement or stability in the symptoms, activity, impact and total score was seen in 14 (78%), 12 (67%), 9 (50%) and 9 (50%) of the patients, respectively. However, half of the patients reported deterioration in the impact domain and total scores. By self-assessment, patients who categorised themselves as "poor" were comparable at the start of OPAT and at 3 months (43% vs 50%, McNemar's P = 0.7). Adverse events attributable to micafungin were recorded in 3 (14.3%) episodes.
Conclusions:
Micafungin may be safely administered via an OPAT service. Micafungin therapy was associated with an improvement or stability in QoL scores in at least 50% of the patients across the four domains.
Insights
Outpatient parenteral antimicrobial therapy (OPAT) with micafungin offers a safe and effective treatment for chronic pulmonary aspergillosis (CPA). This approach improved or maintained quality of life for over half of patients, demonstrating its clinical utility.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- Chronic pulmonary aspergillosis (CPA) often requires long-term treatment.
- Oral triazole therapy may be unfeasible for some CPA patients.
- Intravenous micafungin is an alternative treatment option for CPA.
Purpose of the Study:
- To evaluate the safety and efficacy of micafungin for CPA treatment.
- To assess micafungin administration via the Outpatient Parenteral Antimicrobial Therapy (OPAT) service.
- To determine the impact of micafungin on patient Quality of Life (QoL).
Main Methods:
- Retrospective analysis of CPA patients receiving micafungin via OPAT (April 2016 - March 2018).
- Data collection included adverse events, line complications, and QoL scores (baseline and 3 months).
- QoL improvement defined as ≥4 point increase in St George's QoL score domains.
Main Results:
- 20 OPAT episodes in 18 patients; median micafungin duration 21 days.
- Improvement or stability in QoL scores observed in 50-78% of patients across domains.
- Adverse events attributable to micafungin occurred in 14.3% of episodes.
- Half of patients reported deterioration in impact and total QoL scores.
Conclusions:
- Micafungin can be safely administered through an OPAT service for CPA treatment.
- Micafungin therapy demonstrated improvement or stability in QoL for at least 50% of patients.
- OPAT delivery of micafungin is a viable option for managing CPA.
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