Which antifungal agent is generally preferred for empirical therapy of febrile neutropenia?

For the empirical therapy of febrile neutropenia, Micafungin is the preferred antifungal agent. This preference is largely due to its broad-spectrum activity against many fungal pathogens and its favorable safety profile. Micafungin, a member of the echinocandin class, is particularly effective against Candida species, which are common causes of infections in immunocompromised patients, such as those with neutropenia.

Micafungin is also advantageous because it has minimal drug interactions and can be administered intravenously, ensuring adequate systemic exposure during critical periods when patients are unable to take oral medications. Other antifungal agents may not provide the same level of efficacy or may have limitations in their coverage against certain fungi that can be prevalent in febrile neutropenic patients.

While agents such as Anidulafungin and Voriconazole also have their places in antifungal therapy, particularly in cases involving resistant infections or specific pathogens, Micafungin is typically the first choice due to its robust effectiveness and safety in the context of empirical treatment for febrile neutropenia. Fluconazole, although effective against certain fungal infections, generally lacks the broader spectrum of coverage provided by Micafungin, making it less ideal for