Comparison of Killing Activity of Micafungin Against Six Candida Species Isolated from Peritoneal and Pleural Cavities in RPMI-1640, 10 and 30% Serum

Currently echinocandins are recommended in Candida peritonitis and pleuritis. We determined micafungin killing rates ( k values) at therapeutic concentrations (0.25–2 mg/L) in RPMI-1640 with and without 10 and 30% serum mimicking in vivo conditions against six Candida species isolated from peritoneal and pleural fluid. In RPMI-1640, micafungin was fungicidal against C. glabrata , C. krusei and C. kefyr within 2.27 ± 10.68, 2.69 ± 10.29 and 3.10 ± 4.41 h, respectively, while was fungistatic against C. albicans , C. tropicalis and C. parapsilosis . In 10% serum, ≥ 0.25, ≥ 0.5, ≥ 0.5 and ≥ 1 mg/L micafungin produced positive k values (killing) for all C. albicans , C. glabrata , C. kefyr and C. krusei , respectively. In 30% serum, 2 mg/L micafungin produced killing against all C. albicans , C. glabrata and C. kefyr isolates, but was ineffective against C. krusei , C. parapsilosis and 2 of 3 C. tropicalis . Micafungin exposure should be increased against non- albicans species to eradicate fungi from peritoneal and pleural cavities.