Use of Micafungin for the Prevention and Treatment of Invasive Fungal Infections in Everyday Pediatric Care in France: Results of the MYRIADE Study.

Abstract

BACKGROUND:

Invasive fungal infections are responsible for significant morbidity and mortality. Safety and effectiveness of antifungal agents is a particular concern in pediatric populations, where data are often limited. Micafungin is an echinocandin with demonstrated antifungal activity against a wide spectrum of Candida spp.; this subanalysis of data from the MYRIADE study describes the use of micafungin and its therapeutic outcomes in pediatric patients, in normal clinical practice.

METHODS:

MYRIADE was an observational, multicenter, national, prospective, longitudinal study conducted from January 2010 to December 2012, in patients treated with micafungin using a prophylactic or curative strategy, across 17 sites [oncohematology (n = 8), neonatal intensive care units (ICUs) (n = 5) and pediatric ICUs (n = 4)]. The treatment regimen, the achievement of the therapeutic objective and the tolerance were reported.

RESULTS:

The study population consisted of 110 pediatric patients (31 neonates, 24 children <2 years old and 55 children ≥2 to <16 years old). The therapeutic objective was achieved in 49/64 (76.6%) oncohematology patients, 28/29 (96.6%) neonatal ICU patients and 12/14 (85.7%) pediatric ICU patients. Twenty-four (21.8%) children developed an adverse event (AE); more AEs were observed in oncohematology patients compared with ICU patients [17 (26.1%) vs. 7 (15.6%)]. Only one serious AE, reported in an oncohematology patient, was considered related to micafungin.

CONCLUSIONS:

In the first large observational study of micafungin treatment or prophylaxis conducted under real-world conditions in France, micafungin was effective and well tolerated for prophylaxis of invasive fungal infections in pediatric oncohematology patients and for curative purposes in pediatric and neonatal ICU patients.

• Authors: Guy Leverger, Jean-François Timsit, Noël Milpied, Bertrand Gachot
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 38 Issue 7 Pg. 716-721 (07 2019) ISSN: 1532-0987 [Electronic] United States
• PMID: 31192976 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antifungal Agents
• Micafungin

Topics

• Adolescent
• Antifungal Agents (administration & dosage, adverse effects)
• Candida (isolation & purification)
• Candidiasis, Invasive (drug therapy, prevention & control)
• Chemoprevention (adverse effects, methods)
• Child
• Child, Preschool
• Drug-Related Side Effects and Adverse Reactions (epidemiology)
• Female
• France
• Humans
• Infant
• Infant, Newborn
• Longitudinal Studies
• Male
• Micafungin (administration & dosage, adverse effects)
• Prospective Studies
• Treatment Outcome