Mycamine (micafungin) / Astellas - LARVOL DELTA

Safety and Effectiveness of Micafungin Prophylaxis in Patients Receiving 7+3 Chemotherapy with FLT3 Inhibitor for Acute Myeloid Leukemia (HOPA 2026) - "Background/Rationale: FMS-like tyrosine kinase (FLT3) gene mutations occur in approximately 30% of patients with newly diagnosed acute myeloid leukemia (AML).1 Two FLT3 inhibitors (FLT3i), midostaurin and quizartinib, are approved for frontline treatment of FLT3-positive AML in combination with 7+3 (cytarabine plus daunorubicin/idarubicin).2 Grade 3 neutropenia is common with 7+3+FLTi therapy, necessitating invasive fungal infection (IFI) prophylaxis. These results demonstrate the safe and efficacious use of micafungin for IFI prophylaxis in patients with AML treated with 7+3+FLT3i therapy. Rates of IFIs in this cohort were similar to historical comparators utilizing mold-active azoles for antifungal prophylaxis. 5,6 Notably, most IFIs in this study were classified as possible, with rates of proven IFIs comparable to those previously reported with mold-active azoles.5,6 Additionally, rates of FLT3i dose change, induction response outcomes, and hematologic recovery were..."

Clinical • Acute Myelogenous Leukemia • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Neutropenia • FLT3

Candida auris as an emerging threat in intensive care units: A single-center retrospective study. (PubMed, IJID Reg) - "All isolates remained susceptible to caspofungin and micafungin, and voriconazole susceptibility was inferred based on fluconazole minimum inhibitory concentration values. Despite these interventions, delayed detection and limited access to reference susceptibility testing remained major challenges. These findings highlight the need for strengthened active surveillance, rapid diagnostic capacity, and standardized susceptibility testing to reduce nosocomial transmission and improve clinical outcomes in high-risk intensive care settings."

Journal • Retrospective data • Review • Critical care • Infectious Disease

MICAFUNGIN AS ANTIFUNGAL PROPHYLAXIS DURING THE PRE-ENGRAFTMENT PERIOD OF ALLO-HSCT. ANALYSIS OF A 450-PATIENT COHORT (EBMT 2026) - " Table 1: "Baseline characteristics of patients undergoing allo-HSCT receiving micafungin prophylaxis"; n = 450HSCT: Hematopoietic stem cell transplantation; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; MDS: Myelodysplastic síndrome; GVHD: Graft-versus-host disease; MAC: Myeloablative conditioning; RIC: Reduced-intensity conditioning; Cs: Cyclosporine; MTX: Methotrexate; MF: Mycophenolate mofetil; CF post: Post-transplant cyclophosphamide; ATG: Antithymocyte globulin...Two azole-resistant and one anidulafungin-resistant Candida isolates were detected...Among patients with proven or possible IFI (n=34), 26.5% had received corticosteroids during the pre-engraftment period.Antifungal treatments were heterogeneous: liposomal amphotericin B (37.9%), isavuconazole (24.1%), and double-agent combinations (24.1%), mainly in critically ill patients with severe pneumonia or intensive care needs.IFI was the primary cause of death in 3 of 19 patients..."

Clinical • Acute Lymphocytic Leukemia • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Candidiasis • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Mucositis • Myelodysplastic Syndrome • Pneumonia • Respiratory Diseases

MICAFUNGIN AS ANTIFUNGAL PROPHYLAXIS DURING THE PRE-ENGRAFTMENT PERIOD OF ALLO-HSCT. ANALYSIS OF A 450-PATIENT COHORT (EBMT 2026) - " Table 1: "Baseline characteristics of patients undergoing allo-HSCT receiving micafungin prophylaxis"; n = 450HSCT: Hematopoietic stem cell transplantation; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; MDS: Myelodysplastic síndrome; GVHD: Graft-versus-host disease; MAC: Myeloablative conditioning; RIC: Reduced-intensity conditioning; Cs: Cyclosporine; MTX: Methotrexate; MF: Mycophenolate mofetil; CF post: Post-transplant cyclophosphamide; ATG: Antithymocyte globulin...Two azole-resistant and one anidulafungin-resistant Candida isolates were detected...Among patients with proven or possible IFI (n=34), 26.5% had received corticosteroids during the pre-engraftment period.Antifungal treatments were heterogeneous: liposomal amphotericin B (37.9%), isavuconazole (24.1%), and double-agent combinations (24.1%), mainly in critically ill patients with severe pneumonia or intensive care needs.IFI was the primary cause of death in 3 of 19 patients..."

Clinical • Acute Lymphocytic Leukemia • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Candidiasis • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Mucositis • Myelodysplastic Syndrome • Pneumonia • Respiratory Diseases

CLINICAL, LABORATORY, AND PHARMACOLOGICAL FACTORS INFLUENCING CALCINEURIN INHIBITOR PLASMA LEVELS IN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS (EBMT 2026) - "Background: Calcineurin inhibitors (CNIs), particularly cyclosporine (CSA) and tacrolimus (TAC), are essential for graft-versus-host disease (GVHD) prophylaxis after allogeneic hematopoietic cell transplantation (HCT)...Separate linear mixed-effects models (LME) were developed for CSA and TAC to evaluate associations between plasma levels and key covariates: age, sex, race, body weight, creatinine, AST/TGO, ALT/TGP, albumin, hematocrit, antifungal exposure (fluconazole, micafungin, voriconazole), and day since CNI initiation... CNI plasma levels are influenced by drug-specific patterns involving clinical, laboratory, and pharmacological factors. CSA exposure was primarily shaped by weight and hematocrit, whereas TAC demonstrated additional associations with age, sex, hepatic function, and micafungin use, reflecting its more complex metabolism. These findings suggest that part of the variability in CNI levels is predictable and occasionally modifiable, supporting refined,..."

Clinical • Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Transplantation

ANTIFUNGAL PROPHYLAXIS PATTERNS AND INVASIVE FUNGAL INFECTIONS OUTCOMES IN PAEDIATRIC ALLOGENIC HCT: A MULTICENTRE COHORT STUDY (EBMT 2026) - "Choice of antifungal prophylaxis was classified as non–mould-active (fluconazole), mould-active (including micafungin, liposomal amphotericin B, voriconazole and posaconazole), or mixed (both non-mould active and mould active agents). Antifungal prophylaxis in paediatric allogenic HCT was strongly risk-adapted, with increased mould-active use in patients with prior history of IFI. IFIs occurred across all prophylaxis strategies, with all proven IFIs occurring in patients on fluconazole monotherapy. Most IFIs arose post-engraftment, highlighting the need for consistent, risk-based escalation to mould-active prophylaxis in immunosuppressed children."

Clinical • Infectious Disease • Pediatrics

A CASE OF FLUCONAZOLE-INDUCED ARGININE VASOPRESSIN RESISTANCE (ISN-WCN 2026) - "Acquired AVP-R includes drug-induced AVP-R, and typical causative drugs are lithium, demeclocycline, amphotericin B, and rifampicin.Methods We report a rare case of fluconazole drug-induced AVP-R.Results A 52-year-old woman with type I diabetes was admitted to our hospital because of impaired consciousness. The patient had been in her usual state of health until 2 days before the admission, and her diabetic medications included dapagliflozin, insulin, and metformin...Broad spectrum antibiotics, meropenem and daptomycin, were introduced and continued to control the infection...Initially, micafungin 150 mg q12hr was introduced and then stopped due to liver dysfunction...Desmopressin administration did not increase urine osmolality or reduce urine volume, which demonstrated renal unresponsiveness...FCZ has been rarely reported to cause AVP-R, and its mechanistic is unclear. Careful continuous observation of urinary concentration and serum sodium level are important to..."

Clinical • Atherosclerosis • CNS Disorders • Dermatitis • Genetic Disorders • Hepatology • Immunology • Infectious Disease • Liver Failure • Metabolic Disorders • Obesity • Ocular Infections • Ocular Inflammation • Ophthalmology • Type 1 Diabetes Mellitus

Detecting healthcare-associated transmission and antifungal resistance in Candida auris via whole genome sequencing. (PubMed, J Clin Microbiol) - "WGS detected known genotypic markers for fluconazole (ERG11 Y132F, F126L, and MRR1 N647T) and micafungin (FKS1 F635C) resistance, with the latter emerging during antimicrobial therapy. Whole genome sequencing approaches are key for supporting these efforts, as they can help define clusters of C. auris transmission and can also provide insight into antifungal resistance. Our work provides practical guidance for interpreting genomic data in this setting, helping infection prevention teams respond more effectively to outbreaks and expanding the use of genotypic predictions for antifungal resistance."

Journal • Infectious Disease

Successful treatment with rezafungin following micafungin for relapsing Rasamsonia argillacea species complex pneumonia in a patient with bronchiectasis: a case report (ESCMID Global 2026) - No abstract available

Case report • Clinical • Bronchiectasis • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

In vivo efficacy of micafungin and 5-flucytosine combination against FKS-mutant Candidozyma auris in the non-mammalian host Galleria mellonella (ESCMID Global 2026) - No abstract available

Preclinical

Reversal of phenotypic resistance to echinocandins via in vitro synergistic/additive interactions between 5-flucytosine and micafungin against FKS-mutant Candidozyma auris isolates (ESCMID Global 2026) - No abstract available

Preclinical

First functional evidence of an acquired FKS1 R638S hotspot mutation causing high-level micafungin resistance in Meyerozyma guilliermondii (ESCMID Global 2026) - No abstract available

Successful treatment of a fluconazole low-susceptibility Kodamaea ohmeri bloodstream infection with micafungin: A case report and literature review. (PubMed, IDCases) - "As K. ohmeri is capable of biofilm formation, removal of the infection source appears crucial for favourable outcomes. This case represents successful treatment of a fluconazole low-susceptibility K. ohmeri fungaemia with micafungin, suggesting that this drug may be an effective therapeutic option."

Journal • Diabetes • Infectious Disease • Metabolic Disorders

Physicochemical compatibility and stability of ketamine co-administered with selected supportive care drugs and parenteral nutrition in pediatric oncology. (PubMed, Explor Res Clin Soc Pharm) - "No additional physical incompatibility occurred., but amoxicillin incompatibility was confirmed. Ketamine is safe to co-administer with AmBisome®, cyclizine, hydromorphone, Intralipid®, magnesium sulfate, metoclopramide, micafungin, potassium dihydrogen phosphate, sodium dihydrogen phosphate and vancomycin. Our findings are significant for improving pain management in vulnerable patients simultaneously administered the tested drugs with ketamine."

Journal • Anesthesia • Oncology • Pain • Pediatrics

Hidden in the Gap: A Fatal Presentation of Pyroglutamic (5-Oxoproline) Acidosis (SCCM 2026) - "She was found to have candidemia requiring a prolonged course of micafungin, however due to social drivers of health she remained hospitalized receiving 1000mg acetaminophen every 6 hours for 3 weeks...Acetaminophen was discontinued, she was initiated on N-acetylcysteine and given bicarbonate infusion for management of concomitant hyperkalemia with severe lactic acidosis...Patients often have a nonspecific presentation including, but not limited to, nausea, vomiting, kussmaul respirations, or altered mental status. This case highlights the importance of maintaining a high index of suspicion for 5-oxoproline acidosis in critically ill patients with unexplained metabolic acidosis."

Gynecology • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease • Septic Shock • Solid Tumor • Uterine Cancer

Rare Case of Candida auris Pericarditis in an ESRD Patient With History of Endocarditis (SCCM 2026) - "The patient was initially started on micafungin, but due to lack of clinical response, therapy was switched to liposomal amphotericin B while awaiting susceptibility results. This case underscores the need to consider fungal etiologies in high-risk ICU patients with pericardial effusion and highlights C. auris as an emerging critical care threat that requires enhanced surveillance and infection control measures.Sources: (Ruiz-Gaitán et al., JMM Case Rep 2018). (Chowdhary et al., PLoS Pathog, 2016; CDC, 2024)."

Clinical • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Gastroenterology • Gastrointestinal Disorder • Glomerulonephritis • Hematological Disorders • IgA Nephropathy • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus • Ulcerative Colitis

Associations Between Fungemia and Clinical Outcomes Among Pediatric ECMO Patients (SCCM 2026) - "Fungemia patients more commonly received amphotericin (44% vs 4%), fluconazole (63% vs 31%), and micafungin (63% vs 15%) (all p< 0.001).Fungemia patients had fewer ECMO-free days (48 [0–81] vs 79 [0–85]d), PFDs (0 [0–53] vs. 36 [0–73]d), VFDs (0 [0-59] vs 45 [0-76]d), and higher mortality (48% vs 38%) (all p< 0.001). Among thousands of pediatric ECMO patients in an administrative database, fungemia occurred in approximately 1 of 20 cases and was associated with unfavorable outcomes even after adjusting for confounders. Further research is needed for treatment and prevention strategies in this vulnerable cohort."

Clinical • Clinical data • Infectious Disease • Pediatrics

Drug-Resistant Candida auris and Mucor in Liver Transplant: Fosmanogepix as Salvage Therapy (SCCM 2026) - "His postoperative course was further complicated by a persistent abdominal wall infection involving drug-resistant C. auris and M. circinelloides, unresponsive to amphotericin B, micafungin, and posaconazole. The observed decline in beta-D-glucan and transition to oral therapy contributed to infection control and stabilization. Fosmanogepix may provide a much-needed alternative for transplant recipients with multidrug resistant fungal infections unresponsive to existing therapies."

Fibrosis • Hepatology • Immunology • Infectious Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Respiratory Diseases • Transplantation

Impact of a Pharmacy-Driven (1,3)-β-D-Glucan Algorithm on Micafungin Duration of Therapy in the ICU (SCCM 2026) - "A pharmacy-driven BDG algorithm did not significantly decrease micafungin DOT except with BDG results within 48 hours or with algorithm compliance following negative results. The BDG test may have less impact in immunocompromised, surgery, and dialysis patients. This highlights the need for research in anti-fungal stewardship to optimize patient outcomes."

Candidiasis

Disseminated Mucormycosis with Characteristic Gastric Ulcers and Extensive Intravascular Invasion after ABO-Incompatible Living-Donor Liver Transplantation: A Case Report. (PubMed, Surg Case Rep) - "This case represents a breakthrough mucormycosis infection that developed despite antifungal prophylaxis. The disease manifested as characteristic gastric ulcerations and extensive vascular invasion, leading to fatal outcomes despite liposomal amphotericin B therapy. Necrotic gastric ulcers and positive gastric juice cultures provide critical diagnostic clues. In highly immunosuppressed liver transplant recipients, atypical gastric findings should raise suspicion for mucormycosis, and early systemic evaluation is essential to improve otherwise poor prognoses."

Journal • Fibrosis • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Peptic Ulcer • Septic Shock • Transplantation

A MASS OF UNCERTAINTY: CANDIDA TROPICALIS ENDOCARDITIS PRESENTING AS A LEFT VENTRICULAR MASS (ACC 2026) - "Case: A 77-year-old man with Myelodysplastic Syndrome (MDS) on Imetelstat and an indwelling chemoport presented with bilateral pedal edema...Micafungin was initiated and filgrastim was started for neutropenia... Fungal endocarditis may extend beyond valves and present as an intracavitary or wall-adherent mass in immunocompromised patients with indwelling catheters, requiring high suspicion for diagnosis and management."

Cardiovascular • Hematological Disorders • Hematological Malignancies • Infectious Disease • Myelodysplastic Syndrome • Neutropenia • Pneumonia • Respiratory Diseases • Thrombosis

A CASE OF FUNG‑EYE: POST‑TRANSPLANT PANOPHTHALMITIS DUE TO INVASIVE PULMONARY ASPERGILLOSIS (ACC 2026) - "Due to its high morbidity and mortality, our center implemented an aspergillosis prophylaxis protocol in patients using micafungin for the duration of their index transplant admission...Patient was treated with voriconazole with interval decrease in pulmonary nodules on repeat CT scan. This case illustrates a rare instance of invasive pulmonary aspergillosis infection with associated panophthalmitis. Due to its diagnostic challenges and high mortality, this case emphasizes the importance of early clinical consideration and prompt detection of fungal infections in heart transplant patients - even beyond the initial three-month post-transplant period."

Clinical • Post-transplantation • Cardiovascular • Cataract • Glaucoma • Infectious Disease • Ocular Infections • Ocular Inflammation • Ophthalmology • Respiratory Diseases • Transplantation

A RARE CASE OF FUNGAL PROSTHETIC VALVE ENDOCARDITIS CAUSED BY CANDIDA AURIS (ACC 2026) - "Decision-Making: Micafungin was promptly initiated, antibiotics discontinued, and she underwent urgent redo surgical valve replacement with a 27-mm Mitris bioprosthetic valve... Unlike bacterial endocarditis, where surgery is reserved for complications, fungal endocarditis requires surgical replacement as first-line therapy. Awareness of this distinction is critical for prompt recognition and improved survival."

Clinical • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

SEVERE PROSTHETIC AORTIC VALVE STENOSIS FROM OBSTRUCTIVE FUNGAL ENDOCARDITIS: A RARE PHENOMENON (ACC 2026) - "Management consisted of dual antifungal therapy (micafungin, fluconazole), broad-spectrum antibiotics, hemodynamic optimization, and close imaging surveillance... This case illustrates a uniquely rare presentation of Candida parapsilosis PVE causing severe prosthetic aortic stenosis. It highlights the diagnostic value of multimodal imaging, the importance of early recognition of fungal endocarditis, and the challenges of management when surgical options are not feasible."

Cardiovascular • Genetic Disorders • Hematological Disorders • Infectious Disease • Thrombocytopenia

The emerging global threat of multidrug-resistant Candida auris – A case of deep fungal cutaneous infection (AAD 2026) - "A 78-year-old man with rheumatoid arthritis, treated with methotrexate, suffered a laceration to his left thumb...He was treated with trimethoprim/sulfamethoxazole, itraconazole, doxycycline, levofloxacin, vancomycin, piperacillin/tazobactam, and linezolid without significant improvement...The patient completed twelve weeks of intravenous micafungin with resolution of his lesions...Laboratory identification is extremely challenging, and this, coupled with its ability to evade typical antifungal treatments, makes it a formidable microbe. Our case serves as an example of a deep fungal cutaneous infection caused by Candida auris and highlights the diagnostic and treatment challenges of this newly reported pathogen."

Clinical • Dermatitis • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Rheumatoid Arthritis