MONITORING AND USE OF ANTIMYCOTICS FOR SYSTEMIC USE SUPPLIED BY THE STATE HOSPITAL PHARMACY OF MARSALA (TP), ITALY: MYCAMINE® (MICAFUNGIN)

Abstract

Micafungin is an antimycotic drug and represents an important addition to the available therapies for the treatment of systemic fungal infections. Micafungin is used in the treatment of invasive candidiasis, oesophageal and prophylaxis of Candida infections. It inhibits, in a non-competitive way, the synthesis of 1,3-b-D-glucan, a component of fungal cell wall and is rapidly distributed into the tissues. It has a high-rate bond with respect to plasma protein; the above mentioned bond is independent from the concentration of the drug. It is metabolized through the liver, being not subject to intense metabolic transformations until the excretion. There is no evidence of systemic accumulation after repeated use and the steady-state is reached in 4-5 days. Medical records examined at the State Hospital Pharmacy of Marsala, highlights that, from 01.06.2014 to 01.08.2014, in this hospital 12 vials were used by the patients hospitalized in the department of Intensive Care: 8 patients are aged between 75 and 83 and have a body weight higher than 40 kg; 3 patients are aged between 40 and 60 and have a body weight higher than 40 kg and 1 patient has an age equal to 17 years and has a body weight equal to 40 kg. Two patients need a dose increase, for the others 10 patients the first dose resulted sufficient. Mycamine was used for the treatment of hypovolemic post-operative shock. The most frequently recorded adversereactions were anaemia, hypokalaemia, hypomagnesaemia, phlebitis, nausea, liver problems. Given the different weight of the subjects, the dosage was different.