The Guidelines for Management of Deep-seated
Mycoses 2007 recommend the use of
micafungin as a first-line agent for the treatment of
candidemia. On the package insert, the recommended dose of
micafungin is 50 mg/d. However, the Guidelines recommend a
micafungin dose of 100-150 mg/d. In the present study, we evaluated the relationship between the effectiveness and dose of
micafungin in 42 patients with
candidemia who underwent treatment with
micafungin. We found that the efficacy rate of
micafungin at a dose of 50 mg/d was 40%, whereas that at ≥100 mg/d was 87.5%. Moreover, the treatment was more effective in patients who received ≥100 mg/d of
micafungin as compared to those who received 50 mg/d of
micafungin. Furthermore, we assessed the efficacy of
micafungin according to the Candida species. Among all patients, the efficacy rate of
micafungin was found to be lower in patients infected by Candida parapsilosis as compared to those infected by other Candida species. However, among the patients who received ≥100 mg/d of
micafungin, the efficacy rate in patients infected by Candida parapsilosis was equivalent to that of patients who were infected by other Candida species. Thus, based on the results of the present study, the optimal
micafungin dose for the treatment of
candidemia appears to range from 100 to 150 mg/d, as recommended by the Guidelines.