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Vol. 29. Issue S2.
Micafungina: nuevos retos y nuevas posibilidades en el tratamiento de la infección fúngica invasora
Pages 15-22 (March 2011)
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Vol. 29. Issue S2.
Micafungina: nuevos retos y nuevas posibilidades en el tratamiento de la infección fúngica invasora
Pages 15-22 (March 2011)
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Evidencias científicas que respaldan el uso de micafungina en el tratamiento de la candidiasis invasora
Scientific evidence supporting the use of micafungin in the treatment of invasive candidiasis
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Miguel Montejoa,
Corresponding author
josemiguelmontejo@hotmail.com

Autor para correspondencia.
, Guillermo Quindósb
a Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Barakaldo, y Departamento de Medicina, Facultad de Medicina y Odontología, Universidad del País Vasco-Euskal Herriko Unibertsitatea, Bilbao, España
b Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco-Euskal Herriko Unibertsitatea, Bilbao, España
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Resumen

La micafungina es un lipopéptido semisintético desarrollado a partir de Coleophoma empetri, que bloquea la síntesis de β-1,3-D-glucano, componente esencial de la pared fúngica, mediante la inhibición no competitiva de la β-1,3-D-glucano sintetasa. La micafungina es candidacida dependiente de la dosis con una eficacia in vitro excelente contra la gran mayoría de las especies de Candida, incluyendo especies resistentes a anfotericina B, como Candida lusitaniae, a diferentes azoles, como C. glabrata o C. krusei, y a aislamientos no sensibles a otras equinocandinas. Además, es activa contra las biopelículas de Candida. La micafungina es una indicación terapéutica de primera línea para el tratamiento de las candidemias y candidiasis invasoras en adultos y niños (incluidos los neonatos). Su empleo está autorizado en el tratamiento de las candidiasis invasoras y las esofagitis candidiásicas, y en la profilaxis de las infecciones por Candida en pacientes receptores de trasplante de células precursoras hematopoyéticas o que puedan sufrir períodos de neutropenia prolongados. Micafungina puede utilizarse tanto en el tratamiento como en la prevención de la candidiasis en neonatos, niños, adolescentes, adultos o ancianos. Este hecho la convierte en una herramienta de gran valor en grupos de pacientes donde no está aprobado el uso de otros fármacos antifúngicos.

Palabras clave:
Micafungina
Candida
Candidiasis
Candidemia
Neonatos Actividad
Indicaciones
Biopelículas
Abstract

Micafungin is a semisynthetic lipopeptide developed from Coleophoma empetri, which blocks the synthesis of β-1,3-D-glucan, an essential component of the fungal wall, though non-competitive inhibition of β-1,3-D-glucan synthetase. Micafungin is a dose-dependent candidacidal agent with excellent in vitro efficacy against most Candida spp. including species resistant to amphotericin B, such as Candida lusitaniae, several azoles, such as C. glabrata or C. krusei, and isolates not susceptible to other echinocandins. Moreover, this drug is active against Candida biofilms. Micafungin is a first-line drug for the treatment of candidemias and invasive candidiasis in adults and children (including neonates). This drug is approved for use in the treatment of invasive candidiasis and Candida esophagitis, as well as in the prophylaxis of Candida infections in hematopoietic stem cell transplant recipients or those at risk of prolonged neutropenia. Micafungin can be used both in the treatment and prevention of candidiasis in neonates, children, adolescents, adults, and the elderly, making it highly useful in patient groups in which the use of other antifungal drugs has not been authorized.

Keywords:
Micafungin
Candida
Candidiasis
Candidemia
Neonates
Activity
Indications
Biofilms
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