Pharmacokinetics of micafungin in adult patients with invasive candidiasis and candidaemia

Introduction

Micafungin (MICA) is an antifungal therapy for the treatment of life-threatening fungal infections. Until this study, the pharmacokinetics (PK) of MICA in patients with confirmed invasive candidiasis (IC) or candidaemia (C) had not been studied. We report here the PK of MICA in this patient population.

Methods

We characterised the PK of MICA in neutropenic and non-neutropenic patients with confirmed IC or C. Patients (n = 20) received MICA 100 mg daily for ≥ 14 days. Plasma concentration–time profiles to determine the PK were taken after the first dose (day 1) and on the last day of treatment.

Results

The mean age was 50 years (range: 18–84 years) and mean weight was 67 kg (range: 48–103 kg). There were 13 Caucasians, three Thais, one Black, one Asian Indian, one Mulatto and one Cape Coloured. PK parameters are presented in Figure 1. The mean half-life and mean clearance remained largely unchanged after repeated daily dosing for 14 or 28 days. There was no accumulation of MICA between day 1 and the end of therapy beyond that expected for a drug with linear PK. Systemic exposure to MICA metabolites was low throughout the study and therefore they do not contribute to the therapeutic antifungal effectiveness of MICA.

Figure 1

Conclusion

The PK of MICA in these critically ill patients with IC and C were generally similar to those in earlier studies in healthy adults [1]. These data support previous studies that show MICA requires no loading dose.