Micafungin

NEONATAL NURSES MAY have experience with amphotericin B (a polyene) and fluconazole (an azole) for the treatment of neonatal systemic fungal infections. Recently, micafungin (Mycamine, Astellas Pharm, U.S., Inc., Deerfield, IL; Astellas Pharma Canada, Markham, ON), an echinocandin, a newer class of antifungal agents, has made an appearance in the NICU formulary. Safety and efficacy of micafungin has not been established in pediatric populations.¹ This column describes the mechanism of action, dosing for prophylaxis, and treatment from published pharmacokinetic studies and case studies, adverse effects, and nursing implications for micafungin.