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Efficacy of micafungin in empirical therapy of deep mycosis in surgically ill patients

  • Original Article
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Journal of Infection and Chemotherapy

Abstract

Micafungin (MCFG), an echinocandin antifungal agent, exhibits antifungal activity against Candida albicans and non-albicans Candida. The fungicidal activity of MCFG against clinical isolates of Candida species was investigated, and the clinical efficacy of MCFG in therapy of deep mycosis in surgery was studied using the AKOTT algorithm. The minimum inhibitory concentration and minimum fungicidal concentration values of fluconazole were ≤0.06–4 and >64 μg/ml, respectively, for each strain, whereas these values of MCFG were 0.008–0.5 and 0.016–1 μg/ml, suggesting that MCFG provided superior fungicidal ability against Candida albicans and non-albicans Candida. The subjects were separated into two groups: group A consisted of 20 subjects with both persisting fever refractory to broad-spectrum antibiotics and positive reaction to β-d-glucan test, and group B consisted of 20 subjects with either of those conditions. The overall response was evaluated as “effective” in 17 patients (85%) and 20 patients (100%) in groups A and B, respectively. In total, response was evaluated as “effective” in 37 patients (92.5%) and “ineffective” in 3 patients (7.5%). These findings suggest that MCFG administration should be used as empirical therapy for deep mycosis in surgically ill patients as it was shown to be an effective antifungal drug lacking serious adverse effects.

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References

  1. Fraser VJ, Jones M, Dunkel J, Storfer S, Medoff G, Dunagan WC. Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin Infect Dis. 1992;15:414–21.

    Article  PubMed  CAS  Google Scholar 

  2. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med. 1988;148:2642–5.

    Article  PubMed  CAS  Google Scholar 

  3. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP. Risk factors for hospital-acquired candidemia. A matched case-control study. Arch Intern Med. 1989;149:2349–53.

    Article  PubMed  CAS  Google Scholar 

  4. Obayashi T, Yoshida M, Mori T, Goto H, Yasuoka A, Iwasaki H, et al. Plasma (1→3)-β-D-glucan measurement in diagnosis of invasive deep mycosis and fungal febrile episodes. Lancet. 1995;345:17–20.

    Article  PubMed  CAS  Google Scholar 

  5. Takesue Y, Kakehashi M, Ohge H, Imamura Y, Murakami Y, Sasaki M, et al. Combined assessment of β-d-glucan and degree of Candida colonization before starting empiric therapy for candidiasis in surgical patients. World J Surg. 2004;28:625–30.

    Article  PubMed  Google Scholar 

  6. Oguri T, Misawa S, Nakamura A, Kondo S, Igari J, Mori T. Isolation rate and antifungal drug susceptibility of yeast-like fungi isolated from blood or vascular catheter. Kansenshogaku Zasshi. 2006;80:656–64.

    PubMed  Google Scholar 

  7. Presterl E, Daxböck F, Graninger W, Willinger B. Changing pattern of candidaemia 2001–2006 and use of antifungal therapy at the University Hospital of Vienna, Austria. Clin Microbiol Insect. 2007;13:1072–6.

    Article  CAS  Google Scholar 

  8. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007;20:133–63.

    Article  PubMed  CAS  Google Scholar 

  9. 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.

    Article  PubMed  CAS  Google Scholar 

  10. Aikawa N, Kusachi S, Oda S, Takesue Y, Tanaka H. Clinical effects of micafungin, a novel echinocandin antifungal agent, on systemic fungal infections in surgery, emergency, and intensive-care medicine: evaluation using the AKOTT algorithm. J Infect Chemother. 2009;15:219–27.

    Article  PubMed  CAS  Google Scholar 

  11. National Committee for Clinical Laboratory Standards. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard. NCCLS document M27-A. Wayne, PA: National Committee for Clinical Laboratory Standards; 1997.

  12. 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(9572):1519–27.

    Article  PubMed  CAS  Google Scholar 

  13. Hebert MF, Blough DK, Townsend RW, Allison M, Buell D, Keirns J, et al. Concomitant tacrolimus and micafungin pharmacokinetics in healthy volunteers. J Clin Pharmacol. 2005;45:1018–24.

    Article  PubMed  CAS  Google Scholar 

  14. Niwa T, Shiraga T, Takagi A. Drug–drug interaction of antifungal drugs. Yakugaku Zasshi. 2005;125:795–805.

    Article  PubMed  CAS  Google Scholar 

  15. De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813–21.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. The Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan

    Kohji Okamoto, Takefumi Katsuki, Toshihisa Tamura, Shuichi Kanemitsu, Noritaka Minagawa, Takayuki Torigoe, Kazunori Shibao, Aiichirou Higure & Koji Yamaguchi

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  1. Kohji Okamoto
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  2. Takefumi Katsuki
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  3. Toshihisa Tamura
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  4. Shuichi Kanemitsu
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  5. Noritaka Minagawa
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  6. Takayuki Torigoe
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  7. Kazunori Shibao
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  8. Aiichirou Higure
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  9. Koji Yamaguchi
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Correspondence to Kohji Okamoto.

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Okamoto, K., Katsuki, T., Tamura, T. et al. Efficacy of micafungin in empirical therapy of deep mycosis in surgically ill patients. J Infect Chemother 18, 621–629 (2012). https://doi.org/10.1007/s10156-012-0381-z

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  • DOI: https://doi.org/10.1007/s10156-012-0381-z

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