In a nutshell
This study aimed to compare the effectiveness and tolerability of micafungin (Mycamine) and posaconazole (Noxafil) in acute leukemia patients undergoing chemotherapy. This study concluded that micafungin was effective as an antifungal prophylaxis in these patients.
Some background
Invasive fungal infections (IFIs) are common in patients receiving intensive chemotherapy for acute leukemia. IFIs are associated with reduced quality of life and patient outcomes. Antifungal prophylaxis (treatment to prevent disease) is used for patients who have prolonged neutropenia due to chemotherapy. Neutropenia is an abnormally low levels of neutrophils (white blood cells) that help fight infections.
Posaconazole is a commonly used antifungal, but it is associated with multiple negative side effects and must be taken by mouth. Micafungin is another type of antifungal that has been shown to be effective. It can be delivered through an IV (tube inserted directly into a vein). It is not clear which of these antifungals would be more effective and tolerable.
Methods & findings
This study involved 113 patients with acute leukemia or myelodysplastic syndrome undergoing chemotherapy. 58 patients were treated with micafungin and 55 were treated with posaconazole. Patients were followed for 12 weeks to measure rates of antifungal failure. This included early stopping of treatment due to infection, intolerance, adverse event, or death.
Prophylaxis failure occurred in 34.5% of patients in the micafungin group compared to 52.7% in the posaconazole group. Micafungin failures were largely due to antifungal treatment. Posaconazole failures were mostly due to gastrointestinal intolerance or adverse effects. The average number of days on prophylaxis was 16 for the micafungin group compared to 13 for the posaconazole group.
Fungal infection incidence and survival were similar between the groups.
The bottom line
This study concluded that micafungin is suitable for use as antifungal prophylaxis in patients with AL.
What’s next?
Consult your physician about antifungal prophylaxis during chemotherapy treatment.
Published By :
The Journal of infection
Date :
May 07, 2018
