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

Author(s): Sawada A, Sakata N, Higuchi B, Takeshita Y, Ishihara T, Sakata A, Kouroki M, Kondo O, Koyama M, Hirano S, Yasui M, Inoue M, Yoshioka A, Kawa K

Affiliation(s): Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health.

Publication date & source: 2009-12, Rinsho Ketsueki., 50(12):1692-9.

Publication type: Comparative Study; English Abstract; Randomized Controlled Trial

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.

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