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

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  • SAWADA Akihisa
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • SAKATA Naoki
    Department of Pediatrics, Kinki University School of Medicine
  • HIGUCHI Banryoku
    Department of Pediatrics, Nara Medical University
  • TAKESHITA Yasufumi
    Department of Pediatrics, Nara Medical University
  • ISHIHARA Takashi
    Department of Pediatrics, Nara Medical University
  • SAKATA Akifumi
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • KOUROKI Masahiko
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • KONDO Osamu
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • KOYAMA Maho
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • HIRANO Shinya
    Department of Clinical Trials Office, Osaka Medical Center and Research Institute for Maternal and Child Health
  • YASUI Masahiro
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • INOUE Masami
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health
  • YOSHIOKA Akira
    Department of Pediatrics, Nara Medical University
  • KAWA Keisei
    Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health

Bibliographic Information

Other Title
  • 小児の化学療法および造血幹細胞移植での好中球減少期間におけるミカファンギンとホスフルコナゾールによる侵襲性真菌感染症予防の無作為割り付け試験成績
  • 臨床研究 小児の化学療法および造血幹細胞移植での好中球減少期間におけるミカファンギンとホスフルコナゾールによる侵襲性真菌感染症予防の無作為割り付け試験成績
  • リンショウ ケンキュウ ショウニ ノ カガク リョウホウ オヨビ ゾウケツ カンサイボウ イショク デ ノ コウ チュウキュウ ゲンショウ キカン ニ オケル ミカファンギン ト ホスフルコナゾール ニ ヨル シンシュウセイ シンキン カンセンショウ ヨボウ ノ ムサクイ ワリツケ シケン セイセキ

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Description

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.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 50 (12), 1692-1699, 2009

    The Japanese Society of Hematology

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