Journal Article

Second-line therapy with caspofungin for mucosal or invasive candidiasis: results from the caspofungin compassionate-use study

Nicholas A. Kartsonis, Alfred Saah, C. Joy Lipka, Arlene Taylor and Carole A. Sable

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 5, pages 878-881
Published in print May 2004 | ISSN: 0305-7453
Published online May 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh179
Second-line therapy with caspofungin for mucosal or invasive candidiasis: results from the caspofungin compassionate-use study

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Objectives: To prospectively assess the efficacy and safety of caspofungin as second-line therapy for mucosal or invasive candidiasis in patients enrolled in the caspofungin compassionate-use study.

Materials and methods: Thirty-seven patients with mucosal or invasive candida infections (17 oesophageal, four oropharyngeal and 16 invasive candidiasis) were enrolled in the caspofungin compassionate-use study. All patients were refractory to or intolerant of intravenous amphotericin B or lipid amphotericin formulation(s). Efficacy was assessed at the end of intravenous caspofungin therapy based on clinical (and, where appropriate, microbiological) response.

Results: HIV was the most common (91%) risk factor in patients with mucosal candidiasis; patients with invasive candidiasis commonly had acute leukaemia/lymphoma (50%) or diabetes mellitus (31%). Most patients with mucosal candidiasis (91%) and invasive candidiasis (94%) were refractory to ≥1 antifungal agent(s). A favourable response was noted in 82% (14/17) with oesophageal candidiasis, 100% (4/4) with oropharyngeal candidiasis and 87% (13/15) with invasive candidiasis. Caspofungin was generally well tolerated; one serious drug-related adverse event was reported.

Conclusion: In this study, caspofungin was an effective alternative for patients with refractory candida infections.

Keywords: Keywords: Candida, echinocandins, novel antifungal treatment

Journal Article.  2763 words. 

Subjects: Medical Oncology ; Critical Care

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