Efficacy and safety of micafungin for the prophylaxis of invasive fungal infection during neutropenia in children and adolescents undergoing allogeneic hematopoietic SCT

Hj, Park; Park, M; Han, Ming; Nam, B-H; Koh, Katsuyoshi; Hj, Im; Jw, Lee; Ng, Chung; B, Cho; Hk, Kim; Kh, Yoo; Hh, Koo; Hj, Kang; Hy, Shin; Ahn, Hyo Hyun; Yt, Lim; Kook, Hoon; Lyu, Chuhl Joo; Jo, Hah; Je, Park Jung; Yj, Lim; Jj, Seo

doi:10.1038/bmt.2014.136

Cited by 16 publications

(11 citation statements)

References 22 publications

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“…Again this may reflect the change in the antifungal stewardship for neutropenic patients. Indeed, echinocandin drugs, which emerged as valuable options of choice for either prophylaxis, pre-emptive or empirical therapy, have no effect on Trichosporon (Asada et al, 2006 ; Matsue et al, 2006 ; Hiramatsu et al, 2008 ; Suzuki et al, 2010 ; Park et al, 2014 ; Nachbaur et al, 2015 ). Our review supports this re-emergence with a significant increase of reported cases in the second part of the 2000s decade.…”

Section: Discussionmentioning

confidence: 99%

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

2016

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Objectives: This review aimed to better depict the clinical features and address the issue of therapeutic management of Trichosporon deep-seated infections.Methods: We comprehensively reviewed the cases of invasive Trichosporon infection reported in the literature from 1994 (date of taxonomic modification) to 2015. Data from antifungal susceptibility testing (AST) studies were also analyzed.Results: Two hundred and three cases were retained and split into four groups: homeopathy (n = 79), other immunodeficiency conditions (n = 41), miscellaneous (n = 58) and newborns (n = 25). Trichosporon asahii was the main causative species (46.7%) and may exhibit cross-resistance to different antifungal classes. The unfavorable outcome rate was at 44.3%. By multivariate analysis, breakthrough infection (OR 2.45) was associated with unfavorable outcome, whilst the use of an azole-based therapy improved the prognosis (OR 0.16). Voriconazole-based treatment was associated with favorable outcome in hematological patients (73.6 vs. 41.8%; p = 0.016). Compiled data from AST demonstrated that (i) T. asahii exhibits the highest MICs to amphotericin B and (ii) voriconazole has the best in vitro efficacy against clinical isolates of Trichosporon spp.Conclusions: Trichosporon infection is not only restricted to hematological patients. Analysis of compiled data from AST and clinical outcome support the use of voriconazole as first line therapy.

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Section: Discussionmentioning

confidence: 99%

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

2016

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“…Only 1.4% discontinued the micafungin therapy due to adverse effects. The study concluded that micafungin therapy could be a promising clinical approach in preventing fungal infections during allogeneic haematopoietic stem cell transplantation …”

Section: Clinical Trialsmentioning

confidence: 99%

Echinocandins in antifungal pharmacotherapy

Patil

Majumdar

2017

Journal of Pharmacy and Pharmacology

111

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Objectives Echinocandins are the newest addition of the last decade to the antifungal armamentarium, which, owing to their unique mechanism of action, selectively target the fungal cells without affecting mammalian cells. Since the time of their introduction, they have come to occupy an important niche in the antifungal pharmacotherapy, due to their efficacy, safety, tolerability and favourable pharmacokinetic profiles. This review deals with the varying facets of echinocandins such as their chemistry, in-vitro and in-vivo evaluations, clinical utility and indications, pharmacokinetic and pharmacodynamic profiles, and pharmacoeconomic considerations.Key findings Clinical studies have demonstrated that the echinocandins -caspofungin, micafungin and anidulafungin -are equivalent, if not superior, to the mainstay antifungal therapies involving amphotericin B and fluconazole. Moreover, echinocandin regimen has been shown to be more cost-effective and economical. Hence, the echinocandins have found favour in the management of invasive systemic fungal infections. Conclusions The subtle differences in echinocandins with respect to their pharmacology, clinical therapy and the mechanisms of resistance are emerging at a rapid pace from the current pool of research which could potentially aid in extending their utility in the fungal infections of the eye, heart and nervous system.

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“…68 Recent guidelines recommend considering micafungin as an alternate agent for antiyeast prophylaxis in the early post-engraftment setting. 25,[69][70][71] The use of micafungin as opposed to fluconazole for antifungal prophylaxis has been associated with modest reductions in the cost of HCT hospitalizations, potentially because of lower need for empiric antifungal therapy and a lower rate of breakthrough infections. 72,73 A limitation of routine echinocandin use is that they are currently only available as IV agents and continuation in the outpatient setting may be inconvenient, requiring daily clinic attendance or home infusion therapy.…”

Section: Options For Antifungal Prophylaxismentioning

confidence: 99%

Foiling fungal disease post hematopoietic cell transplant: review of prophylactic strategies

Rubinstein

Culos

Savani

et al. 2017

Bone Marrow Transplant

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Hematopoietic cell transplantation (HCT) offers definitive management for a wide variety of malignant and nonmalignant diseases. Conditioning regimens and therapies used to prevent and treat GvHD are immune suppressive, often increasing the risk of developing fungal disease due to yeasts or molds. Antifungal prophylaxis may be useful in preventing morbidity and mortality during and after HCT. In this article, we review the epidemiology and current literature regarding strategies for prevention of invasive fungal disease (IFD) in the pre-engraftment and post-engraftment settings, and propose future direction for scientific discovery.

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Efficacy and safety of micafungin for the prophylaxis of invasive fungal infection during neutropenia in children and adolescents undergoing allogeneic hematopoietic SCT

Cited by 16 publications

References 22 publications

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen

Echinocandins in antifungal pharmacotherapy

Foiling fungal disease post hematopoietic cell transplant: review of prophylactic strategies

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