In vitro antifungal activity of micafungin

Background: Micafungin is a new and very useful pharmacological tool for the treatment of invasive mycoses with a wide antifungal spectrum for the most common pathogenic fungi. Micafungin is especially active against the genera Candida and Aspergillus. its antifungal mechanism is based on the inhibition of the beta-1.3D-glucan synthesis, an essential molecule for the cell wall architecture, with different consequences for Candida and Aspergillus, being micafungin fungicide for the former and fungistatic for the latter. Aim: To describe the in vitro antifungal spectrum of micafungin based in The scientific and medical literature of recent years. Methods: We have done a bibliographic retrieval using the scientific terms, "micafungin", "activity", "Candida", "Aspergillus", "fungi",. "mycos*", "susceptibility", in PubMed/Medline from the National Library of Medicine de EE.UU. from 2005 to 2009. Results: We can underline that most than 99Z of Candida isolates are susceptible to <= 2 mu g/ml of micafungin. MIC are very low (<= 0.125 mu Lg/ml) for most clinical isolates of the species Candida albicans, Candida glabrata, Candida tropicalis and Candida krusei while Candida parapsilosis and Candida gulliermondii isolates are susceptible to anidulafungin concentrations <= 2 mu g/ml. The activity of micafungin is excellent against those medical important species of Aspergillus. However, its activity is very low against Cryptococcus and the Zygomycetes. Conclusions: The excellent activity of micafungin has made this antifungal a first line therapeutic indication for candidemia and invasive candidiasis in non-neutropenic patients. (C) 2009 Revista Iberoamericana de Micologia. Published by Elsevier Espana, S.L. All rights reserved.