Treatment of invasive fungal infections in intensive care units with micafungin: The MYRIADE study.
antifungal agents
candidiasis
critical care
invasive
invasive fungal infections
micafungin
patient
safety
treatment outcome
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
07
01
2020
accepted:
08
02
2020
pubmed:
13
2
2020
medline:
11
11
2020
entrez:
13
2
2020
Statut:
ppublish
Résumé
Invasive fungal infections (IFIs) contribute significantly to nosocomial illness in intensive care units (ICUs). Current practice guidelines recommend echinocandins, such as micafungin, for the treatment of invasive candidiasis. However, limited information on their use in real-world practice is available. To describe the conditions of the use of micafungin in daily clinical practice and to evaluate its effectiveness and tolerability under real-world conditions. This observational, prospective, multicentre study was performed in 34 ICUs in France. The study population consisted of 275 patients ≥16 years old who received treatment with micafungin during the inclusion period. Dose and duration of treatment were at the discretion of the physician. Proven invasive candidiasis was documented before treatment in 106 patients (38.6%); 263 patients (95.6%) received the recommended dose (100 mg/day); 78 patients (28.8%) were treated for the recommended duration. A successful outcome was observed for 217 patients (79.2%). This proportion was significantly higher (83.3%; P < .0001) in patients treated for ≥14 days. Three patients discontinued treatment due to an adverse event considered related to micafungin. No clear impact of micafungin on hepatic function was observed. Micafungin was effective in >75% of patients treated for IFIs in ICUs in France; outcomes may be improved with closer adherence to the recommended treatment duration.
Sections du résumé
BACKGROUND
BACKGROUND
Invasive fungal infections (IFIs) contribute significantly to nosocomial illness in intensive care units (ICUs). Current practice guidelines recommend echinocandins, such as micafungin, for the treatment of invasive candidiasis. However, limited information on their use in real-world practice is available.
OBJECTIVE
OBJECTIVE
To describe the conditions of the use of micafungin in daily clinical practice and to evaluate its effectiveness and tolerability under real-world conditions.
PATIENTS/METHODS
METHODS
This observational, prospective, multicentre study was performed in 34 ICUs in France. The study population consisted of 275 patients ≥16 years old who received treatment with micafungin during the inclusion period. Dose and duration of treatment were at the discretion of the physician.
RESULTS
RESULTS
Proven invasive candidiasis was documented before treatment in 106 patients (38.6%); 263 patients (95.6%) received the recommended dose (100 mg/day); 78 patients (28.8%) were treated for the recommended duration. A successful outcome was observed for 217 patients (79.2%). This proportion was significantly higher (83.3%; P < .0001) in patients treated for ≥14 days. Three patients discontinued treatment due to an adverse event considered related to micafungin. No clear impact of micafungin on hepatic function was observed.
CONCLUSION
CONCLUSIONS
Micafungin was effective in >75% of patients treated for IFIs in ICUs in France; outcomes may be improved with closer adherence to the recommended treatment duration.
Substances chimiques
Antifungal Agents
0
Micafungin
R10H71BSWG
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
443-451Subventions
Organisme : Astellas Pharma Europe Ltd
Informations de copyright
© 2020 Blackwell Verlag GmbH.
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