Micafungin for the prophylaxis and treatment of Candida infections

Abstract

Invasive fungal infection is a significant cause of morbidity and mortality worldwide. The incidence of these infections is steadily increasing. In addition, strains resistant to many commonly used antifungal agents are becoming more prevalent. Many new antifungals have become commercially available in recent years, which have vastly improved the ability to treat these infections effectively. Micafungin is one of three commercially available echinocandins available for use in the USA. This class of agents possess a unique mechanism of action that helps to reduce toxicity while maintaining potent antifungal activity. Micafungin is currently approved for the treatment of esophageal candidiasis in adults and is the only in its class approved for the prophylaxis of Candida infection in patients who have undergone hematopoietic stem cell transplantation. It was also recently approved in the USA for the treatment of candidemia and other forms of invasive candiaisis (acute disseminated candiaisis, Candida peritonitis and abscess). In general, micafungin is well tolerated and has favorable safety and drug-interaction profiles.

Keywords::

• antifungal
• candidiasis
• echinocandin
• micafungin

Financial & competing interests disclosure

ER Dubberke has been a member of the speakers’ bureau for Viropharma Incorporated, Enzon Pharmaceuticals, Pfizer Inc., and Schering-Plough Corporation. He has served on the advisory board of Genzyme Corporation, Salix Pharmaceuticals, Astellas Pharma Inc., and Schering-Plough Corporation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

AUC_0-∞: Area under the concentration curve from time 0 to infinity (in healthy subjects); C_max: Peak plasma concentration (in healthy subjects); SD: standard deviation.

Data from [10,49].