[Comparison of micafungin and fosfluconazole as prophylaxis for invasive fungal infection during neutropenia in children undergoing chemotherapy and hematopoietic stem cell transplantation].

Abstract	Invasive fungal infection (IFI) is a serious complication of chemotherapy for hematological malignancies and autologous/allogeneic hematopoietic stem cell transplantation in children and shows a high mortality rate. We performed a randomized trial comparing micafungin (MCFG), a new anti-fungal agent, with fosfluconazole, a prodrug of fluconazole (FF) conventionally used as a prophylactic agent, for prophylaxis against IFI. Cefpirome was administered as prophylaxis against bacterial infection, and meropenem+minocycline as an empiric window therapy for febrile neutropenia. MCFG 2 mg/kg/day (max 100 mg/day) and FF 10 mg/kg/day (max 400 mg/day) were both safe and effective (event free ratio of IFI, MCFG 94.4% vs FF 94.3%) without significant difference. Thus, MCFG is safe and can be used for prophylaxis against IFI in children.
Authors	Akihisa Sawada, Naoki Sakata, Banryoku Higuchi, Yasufumi Takeshita, Takashi Ishihara, Akifumi Sakata, Masahiko Kouroki, Osamu Kondo, Maho Koyama, Shinya Hirano, Masahiro Yasui, Masami Inoue, Akira Yoshioka, Keisei Kawa
Journal	[Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 50 Issue 12 Pg. 1692-9 (Dec 2009) ISSN: 0485-1439 [Print] Japan
PMID	20068276 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References	Echinocandins Lipopeptides Organophosphates Prodrugs Thienamycins fosfluconazole Fluconazole Meropenem Minocycline Micafungin
Topics	Adolescent Child Child, Preschool Drug Therapy, Combination Echinocandins (administration & dosage) Female Fluconazole (administration & dosage, analogs & derivatives) Hematopoietic Stem Cell Transplantation Humans Infant Lipopeptides (administration & dosage) Male Meropenem Micafungin Minocycline (administration & dosage) Mycoses (complications, prevention & control) Neutropenia (complications, therapy) Opportunistic Infections (complications, prevention & control) Organophosphates (administration & dosage) Prodrugs (administration & dosage) Thienamycins (administration & dosage)

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