Micafungin effectiveness to treat pediatric patients with proven candidemia

INTRODUCTION: Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia.We aimed to discuss micafungin effectiveness and side effects to treat proven candidemia in children.
METHODS: In this study, children who were treated for micafungin for proven candidemia between May 2017 and October 2019 were included. The time to achieve negative culture, the liver and renal functions as well as blood counts were recorded using hospital data system.
RESULTS: Forty five patients (52.3%) who received micafungin for proven candidemia were included in the study. Median age of the children who received micafungin due to IC was 4 months ( range: 12 days-216 months). Of 45 invasive candidiasis patients, 10 (22.2%) were neonate, 19 (42.2%) were infant,11 (24.4%) were between 1-5 years old, 5 (11.1%) were between 10-18 years old. Median duration of micafungin treatment to culture negativity for C. albicans related (6, 1-26 days) candidemia episodes was shorter than non-albicans Candida spp related (7, 1-35 days) candidemia episodes (p=0.10). Culture negativity could not be achieved at the end of 14th day of micafungin treatment in 15 of the 45 (33.3%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=6), followed by C. albicans (n=5), C. guilliermondii (n=1), C.tropicalis (n=2) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. None of the patients developed side effects due to micafungin treatment.
DISCUSSION AND CONCLUSION: Micafungin was found to be safe and effective for the treatment of culture proven candidemia in pediatric patients, including neonates.