Safety and Effectiveness of Micafungin in Neonates: A Retrospective Analytical Study from a Tertiary Pediatric Center

Abstract

Background: The incidence of invasive fungal infections in neonatal intensive care units has increased dramatically over the past few decades, partly due to the increased survival rates of preterm neonates. Currently, there are limited studies concerning the usage of Micafungin in neonates. Therefore, the objective of this study was to review our experience with Micafungin regarding its efficiency and side effects. Methods: In this retrospective analytical study, neonates who recieved micafungin for possible or proven invasive Candida infection between July 2017 and February 2020 were included. The time to achieve negative culture, the 14 days survival of the patients and the the liver and renal functions as well as blood counts were recored. Results: Thirty neonates with a median birth weight of 2125 grams were included . All of them were effectively treated with micafungin. Median serum aspartate aminotransferase, alanine aminotransferase, creatinine levels did not increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to Micafungin usage with serum aspartate aminotransferase, alanine aminotransferase, creatinine levels before an after micafungin treatment: 28 IU (13-257) vs 37 IU (18-89), p=0.86; 14 IU (6-180) vs 16 IU (6-50), p=0.74; 0.5 mg/dL (0.3-3.4) vs 0.5 mg/dL (0.4-2.1), p=0.42, respectively. Conclusion, Micafungin is a safe and effective treatment choice both in the treatment of neonatal culture proven or probable invasive candida infections in both term and preterm neonates.