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Clinical Outcomes of Micafungin for Invasive Fungal Infections in the Obese and Nonobese

Summary

This study examined whether obese patients treated with the antifungal drug micafungin for serious fungal infections had different outcomes compared to non-obese patients. Researchers reviewed 378 patient cases and found that both groups had similar success rates of about 50%, suggesting that the standard dose of micafungin works equally well in obese and non-obese patients. These findings suggest that doctors do not need to prescribe higher doses of micafungin specifically for obese patients, though more research is needed to fully understand how obesity affects antifungal treatment.

Background

Echinocandins are favorable first-line options for treating fungal infections due to their efficacy and safety. Current guidelines do not recommend dose adjusting echinocandins for obesity, though evidence suggests pharmacokinetic goals may be difficult to achieve with standard dosing in obese populations. Clinical outcomes data comparing obese and nonobese patients receiving echinocandins remains scarce.

Objective

This study investigated whether obese patients given micafungin for invasive fungal infection have worse clinical outcomes compared to nonobese patients. The primary outcome was to evaluate favorable clinical response in obese versus nonobese patients at the end of antifungal therapy.

Results

Of 600 patients evaluated, 378 were included with 177 in the obese group and 201 in the nonobese group. Favorable clinical response occurred in 49% of the obese group and 51% of the nonobese group (p=0.76). Minor variations existed in baseline characteristics between groups.

Conclusion

These results do not demonstrate a difference in clinical outcomes using micafungin between obese and nonobese patients and do not support the use of higher doses in the obese population. However, it remains unclear whether there is truly no difference or if the lack of difference is due to small sample size, warranting additional research on echinocandins in obese patients.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Retrospective Cohort Study,
  • Source: 10.1093/ofid/ofae631.1230, PMCID: PMC11777800
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