Abstract
Purpose: The purpose of the present study was to evaluate the efficacy and safety of micafungin (MCFG) in the cases of deep-seated mycosis. Subjects: The subjects were nine patients admitted to this advanced emergency medical center. They had a fever that was resistant to broad-spectrum antimicrobial agents and were suspected of deep-seated mycosis because of inflammatory findings and abnormally increased β-D-glucan levels. Results: The dose of MCFG was either 100 mg · day-1 or 150 mg · day-1 and the duration of its administration ranged from 2 to 19 days. The overall clinical efficacy was evaluated by comparing the data obtained before and after MCFG treatment in terms of improvement in the following aspects: clinical symptoms and findings, results of serological tests of fungi, cultivation of fungi, and results of imaging test. Consequently, clinical efficacy was judged in seven patients, while it was judged impossible to evaluate the other two patients. In this result, β-D-glucan levels decreased in all cases, especially 3/7 cases (42.9%) indicated negative point after MCFG treatment. Both of cultivation of fungi and the canditec test were disappeared. Moreover, in all seven patients, body temperature, WBC, CRP, and interleukin-6 (100%) decreased. In addition, chest X-ray resulted in complete response (CR) 2/7 (28.6%), partial response (PR) 5/7 (71.4%). Seven patients were discharged with survivor. No MCFG associated adverse reactions were recognized. Conclusion: Pre-emptive administration of MCFG, which was effective in treating the both albicans and non-albicans Candida infection, to patients diagnosed as β-D-glucan positive led to satisfactory treatment results. MCFG seems to be a first-choice drug for empiric or pre-emptive therapy in the field of emergency or intensive care.
