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Micafungin

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Abstract

  • ▴ Micafungin, an echinocandin antifungal agent with a novel mechanism of action, inhibits β-(l,3)-D-glucan synthase interfering with fungal cell wall synthesis. It shows excellent antifungal activity against a broad range of Candida spp., including azole-resistant strains, and Aspergillus spp. in in vitro and animal studies.

  • ▴ In HIV-positive patients, intravenous micafungin 50–150 mg/day dose-dependently eradicated endoscopically confirmed oesophageal candidiasis, with micafungin 100 and 150 mg/day being more effective than micafungin 50 mg/day and as effective as fluconazole 200 mg/day in a double-blind trial.

  • ▴ In nonblind trials, micafungin (monotherapy or combination therapy) was effective against invasive aspergillosis, candidiasis and candidaemia in paediatric and adult patients with newly diagnosed or refractory infections.

  • ▴ Micafungin 50 mg/day provided significantly better antifungal prophylaxis than fluconazole 400 mg/ day in 882 haematopoietic stem cell transplant recipients in a randomised, double-blind trial. Respective overall success rates were 80% and 73.5%.

  • ▴ Micafungin is generally well tolerated. Adverse events were not dose- or infusion-related with micafungin 12.5–900 mg/day; no histamine-like reactions occurred. Micafungin was as well tolerated as fluconazole, with numerically fewer micafungin recipients discontinuing treatment (4.2% vs 7.2%).

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  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand

    Blair Jarvis, David P. Figgitt & Lesley J. Scott

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  1. Blair Jarvis
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Jarvis, B., Figgitt, D.P. & Scott, L.J. Micafungin. Drugs 64, 969–982 (2004). https://doi.org/10.2165/00003495-200464090-00004

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