Distribution of micafungin in the tissue fluids of patients with invasive fungal infections

The distribution of micafungin (MCFG) in tissue fluids, such as cerebrospinal fluid (CSF), pleural effusions, ascites, and wound tissue fluids, was examined in seven patients with invasive fungal infections. MCFG (100-300 mg) was administered once daily over a 1-h intravenous infusion. Blood and tissue fluid samples were collected from 1 to 24 h after infusion. Although two patients had similar MCFG concentrations in their plasma, the concentrations in the CSF differed between these two patients. The concentration in the CSF of one patient was much higher than the MIC90 for Candida albicans, Candida glabrata, and Aspergillus fumigatus, whereas the MCFG concentration in the CSF of the other patient was comparable to the MIC90. By contrast, MCFG concentrations in pleural effusions, ascites, and wound tissue fluids were above the MIC90. These results suggest that intravenous MCFG may be effective to treat invasive fungal infections that invade the organs and tissues.