Micafungin versus fluconazole for prophylaxis against fungal infections in premature infants

Abstract

Background: We conducted a comparative clinical study to evaluate the prophylactic effects of micafungin (MCFG) and fluconazole (FLCZ) on the incidence of fungal infections in extremely low-birthweight infants who were born at a gestational age of less than 26 weeks and weighed less than 1000 g.

Methods: With a combination of enteral administration of miconazole (6 mg/kg/day), FLCZ and MCFG were administered intravenously at a dose of 5 mg/kg/day and 3 mg/kg/day, respectively. The prophylaxis was classified as a failure when fungal infections were identified within the first 21 days after birth.

Results: The prophylaxis was successful in seven of 18 cases (39%) in the FLCZ group and 15 of 21 cases (71%) in the MCFG group, indicating that the success rate was significantly higher in the latter group.

Conclusion: MCFG was superior to FLCZ as prophylaxis against fungal infections in extremely low-birthweight infants.

Keywords: extremely low-birthweight infants; fluconazole; fungal infections; micafungin; miconazole; prophylaxis.