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Micafungin: A Review in the Prophylaxis and Treatment of Invasive Candida Infections in Paediatric Patients

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Abstract

Intravenous micafungin (Mycamine®; Funguard®), an echinocandin, is approved in the EU for the treatment of invasive candidiasis in children (including neonates) and adolescents (<16 years of age) and as prophylaxis against Candida infections in patients undergoing haematopoietic stem cell transplantation (HSCT) or who are expected to have neutropenia for ≥10 days. This narrative review focuses on the use of micafungin in paediatric indications approved in the EU, which may vary from those approved elsewhere in the world. Micafungin has a broad spectrum of in vitro activity against clinically relevant isolates of Candida spp. (including fluconazole-resistant Candida glabrata isolates), a low propensity for emergence of resistant isolates and a convenient once-daily regimen. In paediatric substudies and a small multinational, phase 3 trial in neonates with proven invasive candidiasis, intravenous micafungin was effective and generally well tolerated in the treatment of candidaemia and other types of invasive candidiasis and as prophylaxis against fungal infections in patients undergoing HSCT. Hence, micafungin remains an important option for the prophylaxis and treatment of invasive Candida infections in paediatric and adult patients.

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Acknowledgements

During the peer review process, the manufacturer of micafungin was offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Lesley J. Scott

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  1. Lesley J. Scott
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Correspondence to Lesley J. Scott.

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The preparation of this review was not supported by any external funding.

Conflict of interest

Lesley Scott is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: A.C. Arrieta, Pediatric Infectious Diseases and Infectious Diseases Clinical Research, Children’s Hospital of Orange County, Orange, CA, USA; M.U. Kocak, Department of Dermatology, Kirikkale University, Kirikkale, Turkey; C. Korfitis, Department of Dermatology, 401 General Army Hospital, Athens, Greece; N. Maximova, Bone Marrow Transplant Unit, IRCCS Burlo Garofolo, Trieste, Italy; E. Roilides, Infectious Diseases Unit, 3rd Department of Paediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece.

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Scott, L.J. Micafungin: A Review in the Prophylaxis and Treatment of Invasive Candida Infections in Paediatric Patients. Pediatr Drugs 19, 81–90 (2017). https://doi.org/10.1007/s40272-016-0211-3

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