ID | 116538 |
著者 |
Kimura, Shun-ichi
Jichi Medical University
Kanda, Yoshinobu
Jichi Medical University
Iino, Masaki
Yamanashi Prefectural Central Hospital
Fukuda, Takahiro
National Cancer Center Hospital
Sakaida, Emiko
Chiba University
Oyake, Tatsuo
Iwate Medical University
Yamaguchi, Hiroki
Nippon Medical School
Fujiwara, Shin-ichiro
Jichi Medical University
Jo, Yumi
Shimane University
Okamoto, Akinao
Fujita Health University
Fujita, Hiroyuki
Saiseikai Yokohama Nanbu Hospital
Takamatsu, Yasushi
Fukuoka University
Saburi, Yoshio
Oita Prefectural Hospital
Matsumura, Itaru
Kindai University
Yamanouchi, Jun
Ehime University
Shiratori, Souichi
Hokkaido University
Gotoh, Moritaka
Tokyo Medical University
Tamura, Kazuo
Fukuoka University
|
キーワード | Neutropenia
D-index
D-index-guided early antifungal therapy
Empirical antifungal therapy
Micafungin
|
資料タイプ |
学術雑誌論文
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抄録 | Objectives: The D-index is defined as the area over the neutrophil curve during neutropenia. The CEDMIC trial confirmed the noninferiority of D-index-guided early antifungal therapy (DET) using micafungin to empirical antifungal therapy (EAT). In this study, we evaluated the efficacy and safety of micafungin in these settings.
Methods: From the CEDMIC trial, we extracted 67 and 113 patients who received micafungin in the DET and EAT groups, respectively. Treatment success was defined as the fulfilment of all components of a five-part composite end point. Fever resolution was evaluated at seven days after the completion of therapy. Results: The proportion of high-risk treatments including induction chemotherapy for acute leukemia and allogeneic hematopoietic stem cell transplantation was significantly higher in the DET group than in the EAT group (82.1% vs. 52.2%). The efficacy of micafungin was 68.7% (95%CI: 56.2–79.4) and 79.6% (71.0–86.6) in the DET and EAT groups, respectively. When we focused on high-risk treatments, the efficacy was 69.1% (55.2–80.9%) and 78.0% (65.3–87.7%), respectively (P = 0.30). There was no significant difference in any of the 5 components between the two groups. Conclusions: The efficacy of micafungin in patients undergoing high-risk treatment was not strongly impaired in DET compared to that in EAT. |
掲載誌名 |
International Journal of Infectious Diseases
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ISSN | 12019712
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cat書誌ID | AA12791510
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出版者 | International Society for Infectious Diseases|Elsevier
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巻 | 100
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開始ページ | 292
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終了ページ | 297
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発行日 | 2020-09-03
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権利情報 | This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
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著者版フラグ |
出版社版
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部局 |
医学系
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