Efficacy and safety of micafungin as an empirical antifungal agent for febrile neutropenic patients with hematological diseases.

BACKGROUND

This observational study was conducted to document the efficacy and safety of the use of micafungin (Mycamine) as an empirical antifungal agent in febrile neutropenic patients.

METHODS

Micafungin was administered for sustained fever (>38.4°C) on days 3-5 following the initiation of empirical antibiotic therapy. The overall success rate and side effects were evaluated.

RESULTS

A total of 47 patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome and lymphoma were enrolled in the study. The overall success rate of micafungin was 61.7% (29/47). A total of 3 patients (6.4%) experienced grade 3/4 elevations in their aspartate aminotransferase levels, and 10 patients (21%) experienced grade 3/4 hyperbilirubinemia, 9 of which resolved. Four patients died of septic shock. Younger patients (<50 years) and patients with acute lymphoblastic leukemia exhibited a better response to micafungin than other patients. Patients that were less profoundly neutropenic (≥0.05 × 10(9)/l) also had a better response to micafungin, as did the patients who recovered from their fever or neutropenia.

CONCLUSION

Micafungin has an excellent efficacy (61.7%) and safety profile when used as an empirical antifungal agent in febrile neutropenic patients with hematological disorders.