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Micafungin as empirical antifungal therapy in hematological patients: a retrospective, multicenter study in the Czech and Slovak Republics

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RÁČIL Zdeněk TOŠKOVÁ Martina KOCMANOVÁ Iva BUREŠOVÁ Lucie KOUBA Michal DRGOŇA Luboš MASÁROVÁ Lucia GUMAN Tomáš TÓTHOVÁ Elena GABZDILOVÁ Juliana FORSTEROVÁ Kristina HABER Jan ŽIAKOVÁ Barbora BOJTÁROVÁ Eva ROLENCOVÁ Monika TIMILSINA Shira CETKOVSKÝ Petr MAYER Jiří

Rok publikování 2013
Druh Článek v odborném periodiku
Časopis / Zdroj Leukemia & Lymphoma
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.3109/10428194.2012.729057
Obor Onkologie a hematologie
Klíčová slova Hematological malignancy; febrile neutropenia; empirical therapy; micafungin
Popis The objective of this retrospective, multicenter study was to evaluate the efficacy and safety of micafungin as empirical antifungal therapy during febrile neutropenia (FN) in 73 hematological patients from 6 centers in two countries. All patients received 100 mg of micafungin/day. The overall favorable response rate (RR) was 64.8% when the resolution of fever during neutropenia was included in the response criteria and 84.5% when excluded. A significantly lower favorable RR in patients with persistent fever and non-specific pulmonary infiltrates compared to patients with persistent fever only (82.8 vs. 52.4%, respectively; p = 0.011) was not found when resolution of fever was not included in the composite endpoint criteria (93.1 vs. 78.6%, respectively; p = 0.180). Breakthrough fungal disease developed in 2.7% patients. Treatment was discontinued in 16.4% of cases. Only one patient (1.4%) discontinued therapy due to an adverse event. Posaconazole prophylaxis improved favorable RR when defervescence was included as composite endpoint criteria (p = 0.047), but not when it was excluded (p = 0.485). However, neutrophil recovery did not influence favorable RR (p = 0.803 and p = 0.112, respectively). These data suggest that micafungin is safe and effective as an empirical therapy in patients with FN.

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