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Micafungin versus Fluconazole for Prophylaxis against Invasive Fungal Infections during Neutropenia in Patients Undergoing Hematopoietic Stem Cell Transplantation
Abstract
We hypothesized that chemoprophylaxis with the echinocandin micafungin would be an effective agent for antifungal prophylaxis during neutropenia in patients undergoing hematopoietic stem cell transplantation (HSCT). We therefore conducted a randomized, double-blind, multi-institutional, comparative phase III trial, involving 882 adult and pediatric patients, of 50 mg of micafungin (1 mg/kg for patients weighing <50 kg) and 400 mg of fluconazole (8 mg/kg for patients weighing <50 kg) administered once per day. Success was defined as the absence of suspected, proven, or probable invasive fungal infection (IFI) through the end of therapy and as the absence of proven or probable IFI through the end of the 4-week period after treatment. The overall efficacy of micafungin was superior to that of fluconazole as antifungal prophylaxis during the neutropenic phase after HSCT (80.0% in the micafungin arm vs. 73.5% in the fluconazole arm [difference, 6.5%]; 95% confidence interval, 0.9%-12%; P=.03). This randomized trial demonstrates the efficacy of an echinocandin for antifungal prophylaxis in neutropenic patients.
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Chiou, C. C., Mavrogiorgos, N., Tillem, E., Hector, R., & Walsh, T. J. (2001) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.45.12.3310-3321.2001 · Cited by 117
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Freifeld, A. G., Bow, E. J., Sepkowitz, K. A., Boeckh, M. J., Ito, J. I., Mullen, C. A., Raad, I. I., Rolston, K. V., Young, J.-A. H., & Wingard, J. R. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir073 · Cited by 3,463
Pappas, P. G., Kauffman, C. A., Andes, D., Benjamin, D. K., Calandra, T. F., Edwards, J. E., Filler, S. G., Fisher, J. F., Kullberg, B.-J., Zeichner, L. O., et al. (2009) · Clinical Infectious Diseases · doi:10.1086/596757 · Cited by 3,191
Self-citationPatterson, T. F., Thompson, G. R., Denning, D. W., Fishman, J. A., Hadley, S., Herbrecht, R., Kontoyiannis, D. P., Marr, K. A., Morrison, V. A., Nguyen, M. H., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw326 · Cited by 2,926
Self-citationUllmann, A. J., Aguado, J. M., Arikan-Akdagli, S., Denning, D. W., Groll, A. H., Lagrou, K., Lass-Flörl, C., Lewis, R. E., Munoz, P., Verweij, P. E., et al. (2018) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2018.01.002 · Cited by 1,556
Cornely, O. A., Bassetti, M., Calandra, T., Garbino, J., Kullberg, B. J., Lortholary, O., Meersseman, W., Akova, M., Arendrup, M. C., Arikan-Akdagli, S., et al. (2012) · Clinical Microbiology and Infection · doi:10.1111/1469-0691.12039 · Cited by 1,217
Metadata
- Authors
- van Burik, J.-A. H., Ratanatharathorn, V., Stepan, D. E., Miller, C. B., Lipton, J. H., Vesole, D. H., Bunin, N., Wall, D. A., Hiemenz, J. W., Satoi, Y., Lee, J. M., Walsh, T. J., & for the National Institute of Allergy and Infectious Diseases Mycoses Study Group
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-11-15
- Volume
- 39
- Issue
- 10
- Pages
- 1407-1416
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2167412063
- Cited by
- 744
- References
- 1
- FWCI
- 25.84
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Micafungin versus Fluconazole for Prophylaxis against Invasive Fungal Infections during Neutropenia in Patients Undergoing Hematopoietic Stem Cell Transplantation. https://app.cochat.ai/papers/10.1086/422312
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- van Burik, J.-A. H., Ratanatharathorn, V., Stepan, D. E., Miller, C. B., Lipton, J. H., Vesole, D. H., Bunin, N., Wall, D. A., Hiemenz, J. W., Satoi, Y., Lee, J. M., Walsh, T. J., & for the National Institute of Allergy and Infectious Diseases Mycoses Study Group. (2004). Micafungin versus Fluconazole for Prophylaxis against Invasive Fungal Infections during Neutropenia in Patients Undergoing Hematopoietic Stem Cell Transplantation. Clinical Infectious Diseases. https://doi.org/10.1086/422312
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
