Scott Lesley J
Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
Paediatr Drugs. 2017 Feb;19(1):81-90. doi: 10.1007/s40272-016-0211-3.
Intravenous micafungin (Mycamine; Funguard), an echinocandin, is approved in the EU for the treatment of invasive candidiasis in children (including neonates) and adolescents (<16 years of age) and as prophylaxis against Candida infections in patients undergoing haematopoietic stem cell transplantation (HSCT) or who are expected to have neutropenia for ≥10 days. This narrative review focuses on the use of micafungin in paediatric indications approved in the EU, which may vary from those approved elsewhere in the world. Micafungin has a broad spectrum of in vitro activity against clinically relevant isolates of Candida spp. (including fluconazole-resistant Candida glabrata isolates), a low propensity for emergence of resistant isolates and a convenient once-daily regimen. In paediatric substudies and a small multinational, phase 3 trial in neonates with proven invasive candidiasis, intravenous micafungin was effective and generally well tolerated in the treatment of candidaemia and other types of invasive candidiasis and as prophylaxis against fungal infections in patients undergoing HSCT. Hence, micafungin remains an important option for the prophylaxis and treatment of invasive Candida infections in paediatric and adult patients.
静脉注射米卡芬净（商品名：Mycamine；Funguard）是一种棘白菌素类药物，在欧盟被批准用于治疗儿童（包括新生儿）和青少年（<16岁）的侵袭性念珠菌病，以及作为接受造血干细胞移植（HSCT）或预计中性粒细胞减少≥10天的患者预防念珠菌感染的药物。本叙述性综述聚焦于米卡芬净在欧盟批准的儿科适应症中的应用，这些适应症可能与世界其他地区批准的有所不同。米卡芬净对临床上相关的念珠菌属分离株（包括对氟康唑耐药的光滑念珠菌分离株）具有广泛的体外活性，耐药菌株出现的倾向较低，且给药方案方便，每日一次。在儿科亚研究以及一项针对确诊为侵袭性念珠菌病的新生儿的小型多国3期试验中，静脉注射米卡芬净在治疗念珠菌血症和其他类型的侵袭性念珠菌病以及作为HSCT患者预防真菌感染方面有效且总体耐受性良好。因此，米卡芬净仍然是儿科和成人患者预防和治疗侵袭性念珠菌感染的重要选择。
