Pozo-Laderas Juan Carlos
Servicio de Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, España.
Rev Iberoam Micol. 2009 Mar 31;26(1):69-74. doi: 10.1016/S1130-1406(09)70012-9. Epub 2009 May 7.
Over the last 30 years a significant increase of Candida spp. invasive disease has been observed in non-neutropenic critical ill patients. Both fluconazole and amphotericin B have been considered first line treatment for invasive (proven and probable) Candida spp. disease, although the mortality rate is still high.
To review the current data on the use of micafungin for the treatment of Candida invasive disease in critical ill patients.
The pharmacologic, mycological and clinical properties of micafungin are reviewed based on current published data. The use and efficacy of micafungin for the treatment of Candida invasive disease in critical ill patients is discussed.
To reduce the rate of mortality more effective antifungals and pre-emptive treatment strategies are currently warranted. Candins achieve better results for the treatment of invasive Candida disease in non-neutropenic critical ill patients. Micafungin has a good safety profile (similar to fluconazole). Micafungin is a first line drug for the treatment of invasive Candida disease and may be used as a pre- emptive approach followed by a de-escalating strategy with azoles.
在过去30年中，非中性粒细胞减少的重症患者念珠菌属侵袭性疾病显著增加。氟康唑和两性霉素B都被视为侵袭性（确诊和疑似）念珠菌属疾病的一线治疗药物，尽管死亡率仍然很高。
综述目前米卡芬净用于治疗重症患者念珠菌侵袭性疾病的数据。
根据当前已发表的数据，对米卡芬净的药理、真菌学和临床特性进行综述。讨论米卡芬净用于治疗重症患者念珠菌侵袭性疾病的使用情况和疗效。
为降低死亡率，目前需要更有效的抗真菌药物和抢先治疗策略。棘白菌素类药物在治疗非中性粒细胞减少的重症患者侵袭性念珠菌病方面取得了更好的效果。米卡芬净具有良好的安全性（与氟康唑相似）。米卡芬净是治疗侵袭性念珠菌病的一线药物，可作为抢先治疗方法，随后采用唑类药物的降阶梯策略。
