Micafungin use in a UK tertiary referral hospital.
J Glob Antimicrob Resist. 2018 Jun 30;:
Authors: Enoch DA, Murphy ME, Micallef C, Yang H, Brown NM, Aliyu SH
OBJECTIVE: We sought to describe the real-life usage of micafungin in our hospital.
METHODS: We performed a prospective non-interventional observational surveillance study in a large teaching hospital.
RESULTS: We commenced micafungin in 174 courses involving 148 patients to treat invasive candidiasis and candidaemia (131 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 EORTC guidelines in 84 courses (49%). Micafungin was well tolerated; 10 patients (7%) developed a rise in ALT and only one patient stopped therapy due to this. Therapy was rationalised to fluconazole in 77 courses (44%). There were no differences in ICU admission or deaths when comparing all 174 courses where patients received micafungin for aspergillus and candida infection respectively (49% versus 42%, p=0.82 and 24% versus 15%, p=0.186). One patient developed disseminated mucormycosis and four patients had recurrent candidaemia (attributed to poor source control) whilst receiving micafungin.
CONCLUSIONS: We conclude that micafungin was clinically effective for the treatment of invasive candida and aspergillus infections and that usage did not increase the risk of liver dysfunction even in patients with abnormal ALT at baseline.
PMID: 29969751 [PubMed – as supplied by publisher]