Micafungin use in a UK tertiary referral hospital

David A. Enoch*, Michael E. Murphy, Christianne Micallef, Huina Yang, Nicholas Brown, Sani H. Aliyu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objectives: Here we sought to describe the real-life usage of micafungin in a UK tertiary referral hospital. Methods: A prospective, non-interventional, observational surveillance study was performed in a large teaching hospital do we need ‘in a large teaching hospital’ now since we say ‘UK tertiary hospital’ above?. Results: Micafungin was commenced in 174 courses involving 148 patients to treat invasive candidiasis and candidaemia (132 courses) and aspergillosis in situations where alternatives such as voriconazole or liposomal amphotericin B could not be used (42 courses). Fungal infection was defined as proven as per European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) guidelines in 84 courses (48.3%). Micafungin was well tolerated; 10 patients (6.8%) developed a rise in alanine aminotransferase (ALT) and only 1 patient stopped therapy due to this. Therapy was rationalised to fluconazole in 77 courses (44.3%). There were no differences in intensive care unit admission or deaths when comparing all 174 courses where patients received micafungin for Aspergillus and Candida infection, respectively [49% vs. 42% (P = 0.82) and 24% vs. 15% (P = 0.186)]. One patient developed disseminated mucormycosis and four patients had recurrent candidaemia (attributed to poor source control) while receiving micafungin. Conclusions: Micafungin was clinically effective for the treatment of invasive Candida and Aspergillus infections, and usage did not increase the risk of liver dysfunction even in patients with abnormal ALT at baseline.

Original languageEnglish
Pages (from-to)82-87
Number of pages6
JournalJournal of Global Antimicrobial Resistance
Volume15
DOIs
Publication statusPublished - Dec 2018

Bibliographical note

Funding Information:
DAE has received funding to attend conferences from MSD, Gilead and Astellas, and has consulted for Astellas and Pfizer; MEM has received funding to attend a conference from Astellas; CM has received travel grants to attend scientific conferences from Astellas, Gilead, Pfizer and Novartis, has received educational grants from Pfizer and Novartis, has attended a Pfizer Advisory Board Meeting and has consulted for Astellas; SHA has served on UK Advisory Boards for Gilead and MSD, and has received sponsorship to attend international meetings from Schering-Plough, Gilead and Wyeth. All other authors declare no competing interests.

Funding Information:
DAE has received funding to attend conferences from MSD , Gilead and Astellas, and has consulted for Astellas and Pfizer; MEM has received funding to attend a conference from Astellas ; CM has received travel grants to attend scientific conferences from Astellas, Gilead , Pfizer and Novartis , has received educational grants from Pfizer and Novartis, has attended a Pfizer Advisory Board Meeting and has consulted for Astellas; SHA has served on UK Advisory Boards for Gilead and MSD, and has received sponsorship to attend international meetings from Schering-Plough, Gilead and Wyeth. All other authors declare no competing interests.

Publisher Copyright:
© 2018 International Society for Chemotherapy of Infection and Cancer

Keywords

  • Aspergillus
  • Candidiasis
  • Micafungin

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