Bassetti Matteo, Giacobbe Daniele Roberto, Vena Antonio, Esposito Susanna
Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
Expert Opin Pharmacother. 2022 Dec;23(18):1987-1993. doi: 10.1080/14656566.2022.2147824. Epub 2022 Nov 22.
Invasive candidiasis remains a leading cause of morbidity and mortality in various categories of patients at risk.
Structure and mechanism of action, pharmacokinetics and pharmacodynamics, clinical studies, safety, and regulatory status of micafungin are explored in the present review, focusing on pediatric patients younger than 4 months old.
Although limited, the available data on the efficacy and safety of micafungin in pediatric patients younger than 4 months old support its use for the treatment of invasive candidiasis in this particular population, in line with the most updated recommendations from the European Medicines Agency and the US Food and Drug Administration. Additional study, especially of high-dose micafungin, could further optimize the use of this drug in pediatric patients younger than 4 months old with meningoencephalitis. The recent worrisome worldwide diffusion of , more frequently resistant to polyenes than to echinocandins and showing high rates of resistance to azoles, could render micafungin even more crucial for guaranteeing an efficacious antifungal treatment for invasive candidiasis in pediatric patients younger than 4 months old.
侵袭性念珠菌病仍然是各类高危患者发病和死亡的主要原因。
本综述探讨了米卡芬净的结构与作用机制、药代动力学和药效学、临床研究、安全性及监管状况，重点关注4个月以下的儿科患者。
尽管数据有限，但关于米卡芬净在4个月以下儿科患者中的疗效和安全性的现有数据支持在这一特定人群中使用其治疗侵袭性念珠菌病，这与欧洲药品管理局和美国食品药品监督管理局的最新建议一致。进一步的研究，尤其是关于高剂量米卡芬净的研究，可能会进一步优化该药物在4个月以下患有脑膜脑炎的儿科患者中的使用。近期全球范围内令人担忧的耳念珠菌传播，其对多烯类药物的耐药性通常高于棘白菌素类，且对唑类药物显示出高耐药率，这可能使米卡芬净对于确保4个月以下儿科患者侵袭性念珠菌病的有效抗真菌治疗变得更加关键。
