Micafungin use in a UK tertiary referral hospital

被引:3
作者
Enoch, David A. [1 ,2 ,4 ,5 ]
Murphy, Michael E. [1 ,2 ,3 ]
Micallef, Christianne [3 ]
Yang, Huina [3 ]
Brown, Nicholas M. [1 ,2 ]
Aliyu, Sani H. [3 ]
机构
[1] Clin Microbiol, Cambridge, England
[2] Publ Hlth England, Publ Hlth Lab, Cambridge, England
[3] Cambridge Univ Hosp NHS Fdn Trust, Cambridge, England
[4] Cambridge Univ Hosp NHS Fdn Trust, Clin Microbiol, Box 236,Hills Rd, Cambridge CB2 0QW, England
[5] Cambridge Univ Hosp NHS Fdn Trust, Publ Hlth Lab, Box 236,Hills Rd, Cambridge CB2 0QW, England
关键词
Micafungin; Candidiasis; Aspergillus; PRIMARY ANTIFUNGAL PROPHYLAXIS; FEBRILE NEUTROPENIA; FUNGAL-INFECTIONS; EFFICACY; MULTICENTER; CANDIDIASIS; PATIENT; SAFETY; CASPOFUNGIN; THERAPY;
D O I
10.1016/j.jgar.2018.06.009
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Here we sought to describe the real-life usage of micafungin in a UK tertiary referral hospital. Methods: A prospective, non-interventional, observational surveillance study was performed. Results: Micafungin was commenced in 174 courses involving 148 patients to treat invasive candidiasis and candidaemia (132 courses) and aspergillosis in situations where alternatives such as voriconazole or liposomal amphotericin B could not be used (42 courses). Fungal infection was defined as proven as per European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) guidelines in 84 courses (48.3%). Micafungin was well tolerated; 10 patients (6.8%) developed a rise in alanine aminotransferase (ALT) and only 1 patient stopped therapy due to this. Therapy was rationalised to fluconazole in 77 courses (44.3%). There were no differences in intensive care unit admission or deaths when comparing all 174 courses where patients received micafungin for Aspergillus and Candida infection, respectively [49% vs. 42% (P = 0.82) and 24% vs. 15% (P = 0.186)]. One patient developed disseminated mucormycosis and four patients had recurrent candidaemia (attributed to poor source control) while receiving micafungin. Conclusions: Micafungin was clinically effective for the treatment of invasive Candida and Aspergillus infections, and usage did not increase the risk of liver dysfunction even in patients with abnormal ALT at baseline. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:82 / 87
页数:6
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