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Distribution of micafungin in the tissue fluids of patients with invasive fungal infections


The distribution of micafungin (MCFG) in tissue fluids, such as cerebrospinal fluid (CSF), pleural effusions, ascites, and wound tissue fluids, was examined in seven patients with invasive fungal infections. MCFG (100–300 mg) was administered once daily over a 1-h intravenous infusion. Blood and tissue fluid samples were collected from 1 to 24 h after infusion. Although two patients had similar MCFG concentrations in their plasma, the concentrations in the CSF differed between these two patients. The concentration in the CSF of one patient was much higher than the MIC90 for Candida albicans, Candida glabrata, and Aspergillus fumigatus, whereas the MCFG concentration in the CSF of the other patient was comparable to the MIC90. By contrast, MCFG concentrations in pleural effusions, ascites, and wound tissue fluids were above the MIC90 . These results suggest that intravenous MCFG may be effective to treat invasive fungal infections that invade the organs and tissues.

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  1. Hatano K, Morishita Y, Nakai T, Ikeda F. Antifungal mechanism of FK463 against Candida albicans and Aspergillus fumigatus. J Antibiot (Tokyo). 2002;55:219–22.

    CAS  Google Scholar 

  2. Tawara S, Ikeda F, Maki K, Morishita Y, Otomo K, Teratani N, et al. In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi. Antimicrob Agents Chemother. 2000;44:57–62.

    PubMed  Article  CAS  Google Scholar 

  3. Takakura S, Fujihara N, Saito T, Kudo T, Iinuma Y, Ichiyama S. National surveillance of species distribution in blood isolates of Candida species in Japan and their susceptibility to six antifungal agents including voriconazole and micafungin. J Antimicrob Chemother. 2004;53:283–9.

    PubMed  Article  CAS  Google Scholar 

  4. Cross SA, Scott LJ. Micafungin: a review of its use in adults for treatment of invasive and oesophageal candidasis and prophylaxis against Candida infections. Drugs. 2008;68:2225–55.

    PubMed  Article  CAS  Google Scholar 

  5. de Wet NT, Bester AJ, Viljoen JJ, Filho F, Suleiman JM, Ticona E, et al. A randomized, double blind, comparative trial of micafungin (FK463) vs. fluconazole for the treatment of oesophageal candidiasis. Aliment Pharmacol Ther. 2005;21:899–907.

    PubMed  Article  Google Scholar 

  6. Tamura K, Urabe A, Yoshida M, Kanamaru A, Kodera Y, Okamoto S, et al. Efficacy and safety of micafungin, an echinocandin antifungal agent, on invasive fungal infections in patients with hematological disorders. Leuk Lymphoma. 2009;50:92–100.

    PubMed  Article  CAS  Google Scholar 

  7. Kuse ER, Chetchotisakd P, da Cunha CA, Ruhnke M, Barrios C, Raghunadharao D, et al. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet. 2007;369:1519–27.

    PubMed  Article  CAS  Google Scholar 

  8. Groll AH, Mickiene D, Petraitis V, Petraitiene R, Ibrahim KH, Piscitelli SC, et al. Compartmental pharmacokinetics and tissue distribution of the antifungal echinocandin lipopeptide micafungin (FK463) in rabbits. Antimicrob Agents Chemother. 2001;45:3322–7.

    PubMed  Article  CAS  Google Scholar 

  9. Yamato Y, Kaneko H, Yamasaki S, Fujiwara T, Katashima M, Ishibashi K, et al. Distribution and excretion after intravenous dosing of [14C]micafingin to rats. Jpn J Chemother. 2002;50(suppl 1):80–7.

    CAS  Google Scholar 

  10. Niwa T, Yokota Y, Tokunaga A, Yamato Y, Kagayama A, Fujiwara T, et al. Tissue distribution after intravenous dosing of micafungin, an antifungal drug, to rats. Biol Pharm Bull. 2004;27:1154–6.

    PubMed  Article  CAS  Google Scholar 

  11. Suzuki T, Uno T, Chen G, Ohashi Y. Ocular distribution of intravenously administered micafungin in rabbits. J Infect Chemother. 2008;14:204–7.

    PubMed  Article  CAS  Google Scholar 

  12. Yamato Y, Kaneko H, Tanimoto K, Katashima M, Ishibashi K, Kawamura A, et al. Simultaneous determination of antifungal drug, micafungin, and its two active metabolites in human plasma using high-performance liquid chromatography with fluorescence detection. Jpn J Chemother. 2002;50(suppl 1):68–73.

    CAS  Google Scholar 

  13. Azuma J, Nakahara K, Kagayama A, Okuma T, Kawamura A, Mukai T. Pharmacokinetic study of micafungin. Jpn J Chemother. 2002;50(suppl 1):155–84.

    Google Scholar 

  14. Okugawa S, Ota Y, Tatsuno K, Tsukada K, Kishino S, Koike K. A case of invasive central nervous system aspergillosis treated with micafungin with monitoring of micafungin concentrations in the cerebrospinal fluid. Scand J Infect Dis. 2007;39:344–6.

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Shinji Ogura.

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Yamada, N., Kumada, K., Kishino, S. et al. Distribution of micafungin in the tissue fluids of patients with invasive fungal infections. J Infect Chemother 17, 731–734 (2011).

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  • Micafungin
  • Echinocandin antifungal
  • Cerebrospinal fluid
  • Pleural effusions
  • Ascites