Micafungin
Micafungin
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DOI：
10.1345/aph.1d301
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发表时间：
2004-10-01
影响因子：
2.9
通讯作者：
Carver, PL
中科院分区：
文献类型：
--
作者：
Carver, PL
目的：对棘球菌素类抗真菌药物米卡芬净的药理、真菌学、化学、体外药敏、药代动力学、临床疗效、安全性、耐受性、剂量和用药进行综述。补充资料来源包括1996年至2003年的抗菌剂和化疗科学间会议和美国传染病学会的计划摘要，以及制造商网站上提供的信息。研究选择和数据提取：对体外和临床前研究以及第二和第三阶段临床试验进行评估，以总结米卡芬净的临床疗效和安全性。所有已发表和未发表的引用米卡芬净的试验和摘要都被选中。数据合成：米卡芬净在体外显示出对许多酵母和各种霉菌的活性。米卡芬净只能通过非肠道给药。HIV感染患者的食道念珠菌病的公开非对比研究以及在接受造血干细胞移植的患者中作为抗真菌预防的对比试验证明了该方法的有效性。不良反应轻微且有限；最常见的不良反应包括高胆红素血症、恶心和腹泻。结论：米卡芬净具有抗曲霉活性。以及各种念珠菌，包括对唑类耐药菌株。米卡芬净在治疗艾滋病毒感染患者的食道念珠菌病方面显示出有效性，在接受造血干细胞移植的患者中作为抗真菌预防措施似乎优于氟康唑。根据病例报告和体外疗效，米卡芬净可能被证明是治疗其他真菌疾病的临床有用药物；然而，这些适应症还有待临床试验的结果。
OBJECTIVE: To review the pharmacology, mycology, chemistry, in vitro susceptibility, pharmacokinetics, clinical efficacy, safety, tolerability, dosage, and administration of micafungin, an echinocandin antifungal agent.DATA SOURCES: A MEDLINE search, restricted to English language, was conducted from 1978 to November 2003. Supplementary sources included program abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America from 1996 to 2003 and information available through the manufacturer's Web site.STUDY SELECTION AND DATA EXTRACTION: In vitro and preclinical studies, as well as Phase II and III clinical trials, were evaluated to summarize the clinical efficacy and safety of micafungin. All published and unpublished trials and abstracts citing micafungin were selected.DATA SYNTHESIS: Micafungin has shown in vitro activity against many yeasts and a variety of molds. Micafungin can be administered only parenterally. Efficacy has been illustrated in open noncomparative studies of esophageal candidiasis in HIV-infected patients and in comparative trials as antifungal prophylaxis in patients undergoing hematopoietic stem-cell transplantation. Adverse events appear mild and limited; the most commonly reported adverse events include hyperbilirubinemia, nausea, and diarrhea.CONCLUSIONS: Micafungin has activity against Aspergillus spp. and a variety of Candida spp., including azole-resistant strains. Micafungin demonstrates efficacy in the treatment of esophageal candidiasis in HIV-infected patients and appears superior to fluconazole as antifungal prophylaxis in patients undergoing hematopoietic stem-cell transplantation. Based on case reports and in vitro efficacy, micafungin may prove to be a clinically useful agent in the treatment of other fungal diseases; however, these indications await the results of clinical trials.