Micafungin
There were 20 facilities administering micafungin for
prophylaxis, almost half of the 45 facilities administering it
for treatment. The mean daily dose of micafungin used for
prophylaxis was 2.7 mg/kg, higher than the package insert
dosage. On the other hand, the mean daily dose of micafungin
for treatment was 4.6 mg/kg, which was in accord
with the Japanese guideline but was slightly higher than
IDSA guidelines recommendations.
Fluconazole
The number of facilities administering fluconazole for
prophylaxis (40 facilities) and for treatment (42 facilities)
was almost the same. The mean daily dose of fluconazole
used for prophylaxis was 6.4 mg/kg, higher than the dosage
recommended by the Japanese guideline. On the other
hand, the mean daily dose of fluconazole used for treatment
was 8.9 mg/kg, slightly lower than the Japanese guideline
dose but in accordance with IDSA guidelines.
Fosfluconazole
The number of facilities administering fosfluconazole for
prophylaxis (40 facilities) and for treatment (42 facilities)
was almost the same, as with fluconazole. The mean daily
dose of fosfluconazole used for prophylaxis was 6.7 mg/kg,
higher than the Japanese guideline recommendation
However, the mean daily dose of fosfluconazole used for
treatment was 8.0 mg/kg, slightly lower than the Japanese
guideline dose.
Voriconazole
Voriconazole was most often administered for treatment
(39 facilities), not for prophylaxis (5 facilities). The mean
daily dose of voriconazole used for prophylaxis was
3.5 mg/kg. The mean daily dose of voriconazole used for
treatment was 7.6 mg/kg, which was in accordance with
IDSA guidelines.
Itraconazole
The number of facilities administering itraconazole for
prophylaxis (22 facilities) and for treatment (14 facilities)
was almost the same, but not as high as fluconazole. The
mean daily dose of itraconazole used for prophylaxis was
4.2 mg/kg. The mean daily dose of itraconazole used for
treatment was 6.2 mg/kg.
Liposomal amphotericin B
Liposomal amphotericin B was mostly used for treatment
(33 facilities) rather than for prophylaxis (2 facilities).
The mean daily dose of liposomal amphotericin B used
for prophylaxis was 2.3 mg/kg. The mean daily dose of
liposomal amphotericin B used for treatment was
Table 2 Usages and dosage of antifungal agents in pediatric patients
Antifungal agents Usage Facilities
reporting use (I)
Dosage mean
(range)
(mg/kg)
Japanese
guideline
(mg/kg)
IDSA
guidelines
(mg/kg)
Dosage in Japanese
package insert (mg/kg)
Micafungin Prophylaxis 20 2.7 (1–4.5) 1
Treatment 45 4.6 (1–7) 3–6 2–4 1–6
Fluconazole Prophylaxis 40 6.4 (1.5–10) 3–6 12
Treatment 42 8.9 (6–10) 10–12 6–12a 3–12
Fosfluconazole Prophylaxis 40 6.7 (1.5–10)
Treatment 42 8 (4.5–10) (FLCZ: 100–400 mg)c
Voriconazole Prophylaxis 5 3.5 (3–6)
Treatment 39 7.6 (4–16) 7 (3–6)c
Itraconazole Prophylaxis 22 4.2 (1–7.5) (200–400 mg)c
Treatment 14 6.2 (4–10) (200–400 mg)c
Liposomal amphotericin B Prophylaxis 2 2.3 (2–2.5)
Treatment 33 4.1 (1–5.5) 3–5b (2.5–5)c
Amphotericin B
deoxycholate
Prophylaxis 13 0.75 (0.75)
Treatment 10 0.8 (0.5–1) 0.25–1 0.5–1a (0.25–1)c
a Recommended as primary therapy in neonatal candidiasis
b Recommended as alternative therapy in neonatal candidiasis
c The dosage for adults
948 J Infect Chemother (2013) 19:946–950
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