Caspofungin Use in Patients with Invasive Candidiasis Caused by Common Non-albicans Candida Species: Review of the Caspofungin Database

Caspofungin Use in Patients with Invasive Candidiasis Caused by Common Non-albicans Candida Species: Review of the Caspofungin Database

Autor Colombo, Arnaldo L. Autor UNIFESP Google Scholar
Ngai, Angela L. Google Scholar
Bourque, Michael Google Scholar
Bradshaw, Susan K. Google Scholar
Strohmaier, Kim M. Google Scholar
Taylor, Arlene F. Google Scholar
Lupinacci, Robert J. Google Scholar
Kartsonis, Nicholas A. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Merck Res Labs
Resumo Increasing rates of invasive candidiasis caused by non-albicans Candida species have been reported worldwide. Particular concerns have been raised for C. parapsilosis because of reduced in vitro susceptibility to echinocandins. We identified 212 patients with invasive candidiasis due to non-albicans Candida species (>= 5 cases per species) in 5 clinical trials of caspofungin monotherapy from the pharmaceutical sponsor's (Merck and Co., Inc.) database: 71 cases were caused by C. parapsilosis, 65 by C. tropicalis, 54 by C. glabrata, 10 by C. krusei, 9 by C. guilliermondii, and 5 by C. lusitaniae. One hundred sixty-seven cases caused by C. albicans were also identified. Efficacy was assessed at the end of caspofungin therapy. Success (favorable overall response) required favorable clinical and microbiological responses. the mean APACHE II scores were 16.5 in the non-albicans group and 15.7 in the C. albicans group. Neutropenia at study entry was more common in the non-albicans group (12%) than in the C. albicans group (5%). the median duration of caspofungin therapy was 14 days in both groups. the success rates were 77% in both groups and at least 70% for each non-albicans species: 74% for C. parapsilosis, 71% for C. tropicalis, 85% for C. glabrata, 70% for C. krusei, 89% for C. guilliermondii, and 100% for C. lusitaniae. the times to negative blood culture were similar for the various species. the overall mortality rates were 26% in the non-albicans group and 29% in the C. albicans group. Drug-related serious adverse events and discontinuations due to caspofungin toxicity were uncommon. Although the sample sizes were limited, caspofungin demonstrated favorable efficacy and safety profiles in the treatment of invasive candidiasis caused by the following non-albicans Candida species: C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. guilliermondii, and C. lusitaniae.
Idioma Inglês
Financiador Merck Co., Inc.
Pfizer
Gilead-United Medical
Data de publicação 2010-05-01
Publicado em Antimicrobial Agents and Chemotherapy. Washington: Amer Soc Microbiology, v. 54, n. 5, p. 1864-1871, 2010.
ISSN 0066-4804 (Sherpa/Romeo, fator de impacto)
Publicador Amer Soc Microbiology
Extensão 1864-1871
Fonte http://dx.doi.org/10.1128/AAC.00911-09
Direito de acesso Acesso aberto Open Access
Tipo Resenha
Web of Science WOS:000276804300029
Endereço permanente http://repositorio.unifesp.br/handle/11600/32489

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