Micafungin

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

Spectrum Of Activity

Dosing

Requires Infectious Disease consultation for use OR completion of the Restricted Antimicrobial order form for approved indications

100 mg IV every 24 hr

General Information

Acceptable Uses

  • Positive blood or other sterile site culture (non-urinary and non-sputum) for Candida species until susceptibilities are available or demonstarting fluconazole resistance

  • Fungal infection empiric therapy, or treatment of patients with solid organ transplant

  • Fungal infection empiric therapy, or treatment of patients receiving cancer chemotherapy with concurrent neutropenia

  • Fungal infection prophylaxis or treatment in hematopoietic stem cell transplant patients

  • Short-term empiric therapy for febrile ICU patients despite antibiotic therapy with sepsis (>38 degree Celsius) AND at least one risk factor for candidemia (risk factors for candidemia have been identified but are of low predictive value when evaluated individually: receipt of parenteral nutrition, gastrointestinal tract surgery during current admission, Candida colonization of multiple body sites, multiple organ failure, esophageal perforation, central line)

  • Combination therapy for refractory mold infection (e.g. aspergillus)

Unacceptable Uses

First line therapy for Candida or aspergillosis infections in non-critically ill patients

Common Usage

Therapy of suspected and confirmed invasive fungal infections

Drug Monitoring

Lab

  • periodic LFTs

Clinical

  • Hypersensitivity

  • GI effects

Adverse Effects

  •  Increased liver enzymes

  •  GI upset

Major Interactions

Increases levels of sirolimus and nifedipine (mild)

Pharmacology

Antimicrobial class: Echinocandin

Pregnancy category: C

Average serum half life: 15 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor