Micafungin as antifungal prophylaxis in non-transplanted haemotological patients

espanolIntroduccion. Las infecciones fungicas son una importante causa de morbilidad y mortalidad en los pacientes hematologicos. Estas infecciones son principalmente debidas a Candida spp.y Aspergillus spp. La mortalidad debida a estas infecciones es alta, pero ha descendido a lo largo de las ultimas series gracias a los mejores agentes antifungicos. Las equinocandinas son, in vitro, muy activas contra Candida y Aspergillus spp. El objetivo de este estudio es analizar la eficacia y seguridad de micafungina en la profilaxis antifungica de pacientes hematologicos en tratamiento quimioterapico. Material y metodos. Un estudio multicentrico, observacional, retrospectivo se llevo a cabo en 7 servicios de Hematologia en Espana. Se incluyeron los pacientes ingresados con quimioterapia o tratamiento inmunosupresor que hubieran recibido micafunfina como profilaxis entre el 1 de enero de 2009 y el 31 de diciembre de 2014. Resultados. Hubo 5 casos de infeccion fungica probable o probada (4,8%) segun los criterios de la EORTC de 2008: 2 probadas, 3 probables. Las infecciones fungicas fueron 3 aspergilosis y 2 candidiasis. No hubo ningun abandono de la profilaxis con micafungina debido a toxicidad. Conclusion. Micafungina es un agente antifungico que, usado en profilaxis, ha demostrado buena eficacia y excelente perfil de toxicidad, siendo una opcion interesante en pacientes que requieren profilaxis antifungica durante su hospitalizacion. EnglishIntroduction. Fungal infections are a major cause of morbidity and mortality in the haematological patients. These infections are mainly due to Candida spp. and Aspergillus spp. Mortality by these infections is high, but rates have descended in the latest series due to better antifungal agents. Echinocandins are, in vitro, very active against Candida and Aspergillus spp. The objective of the study is to analyse the efficacy and safety of micafungin in the antifungal prophylaxis of haematological patients on chemotherapy. Material and methods. A multicentre, observational retrospective study was performed in 7 Haematology Departments in Spain. Patients admitted to these departments with chemotherapy or immunosuppressive treatment, and who had received antifungal prophylaxis with micafungin between 1 January 2009 and 31 December 2014 were included. Results. There were 5 cases of probable or proven fungal infection (4.8%) according to the 2008 EORTC criteria: 2 proven, 3 probable. The types of fungal infection were 3 aspergillosis and 2 candidiasis. There were no drop-outs from the prophylaxis with micafungin due to toxicity. Conclusion. Micafungin is an antifungal agent which, used in prophylaxis, has demonstrated good efficacy and an excellent toxicity profile, making it an apparently interesting option in patients requiring antifungal prophylaxis during their hospitalisation episode.