BACKGROUND: Invasive aspergillosis (IA) is an important cause of morbidity and mortality among immunocompromised patients. Echinocandins are novel antifungal molecules with in vitro and in vivo activity against Aspergillus species. METHODS: We investigated the efficacy and safety of caspofungin in the treatment of IA. Ninety patients with IA who were refractory to or intolerant of amphotericin B, lipid formulations of amphotericin B, or triazoles were enrolled to receive caspofungin. RESULTS: Efficacy was assessed for 83 patients who had infection consistent with definitions of IA and who received >or=1 dose of study drug. Common underlying conditions included hematologic malignancy (48% of patients), allogeneic blood and marrow transplantation (25% of patients), and solid-organ transplantation (11% of patients). Seventy-one patients (86%) were refractory to and 12 patients (14%) were intolerant of previous therapy. A favorable response to caspofungin therapy was observed in 37 (45%) of 83 patients, including 32 (50%) of 64 with pulmonary aspergillosis and 3 (23%) of 13 with disseminated aspergillosis. Two patients discontinued caspofungin therapy because of drug-related adverse events. Drug-related nephrotoxicity and hepatotoxicity occurred infrequently. CONCLUSION: Caspofungin demonstrated usefulness in the salvage treatment of IA.
BACKGROUND:Invasive aspergillosis (IA) is an important cause of morbidity and mortality among immunocompromised patients. Echinocandins are novel antifungal molecules with in vitro and in vivo activity against Aspergillus species. METHODS: We investigated the efficacy and safety of caspofungin in the treatment of IA. Ninety patients with IA who were refractory to or intolerant of amphotericin B, lipid formulations of amphotericin B, or triazoles were enrolled to receive caspofungin. RESULTS: Efficacy was assessed for 83 patients who had infection consistent with definitions of IA and who received >or=1 dose of study drug. Common underlying conditions included hematologic malignancy (48% of patients), allogeneic blood and marrow transplantation (25% of patients), and solid-organ transplantation (11% of patients). Seventy-one patients (86%) were refractory to and 12 patients (14%) were intolerant of previous therapy. A favorable response to caspofungin therapy was observed in 37 (45%) of 83 patients, including 32 (50%) of 64 with pulmonary aspergillosis and 3 (23%) of 13 with disseminated aspergillosis. Two patients discontinued caspofungin therapy because of drug-related adverse events. Drug-related nephrotoxicity and hepatotoxicity occurred infrequently. CONCLUSION:Caspofungin demonstrated usefulness in the salvage treatment of IA.
Authors: J W Hiemenz; I I Raad; J A Maertens; R Y Hachem; A J Saah; C A Sable; J A Chodakewitz; M E Severino; P Saddier; R S Berman; D M Ryan; M J Dinubile; T F Patterson; D W Denning; T J Walsh Journal: Eur J Clin Microbiol Infect Dis Date: 2010-08-12 Impact factor: 3.267
Authors: Francesco Barchiesi; Elisabetta Spreghini; Alfredo Santinelli; Annette W Fothergill; Stefania Fallani; Esther Manso; Eleonora Pisa; Daniele Giannini; Andrea Novelli; Maria I Cassetta; Teresita Mazzei; Michael G Rinaldi; Giorgio Scalise Journal: Antimicrob Agents Chemother Date: 2005-12 Impact factor: 5.191
Authors: A J Ullmann; O A Cornely; A Burchardt; R Hachem; D P Kontoyiannis; K Töpelt; R Courtney; D Wexler; G Krishna; M Martinho; G Corcoran; I Raad Journal: Antimicrob Agents Chemother Date: 2006-02 Impact factor: 5.191
Authors: Robert A Cramer; B Zachary Perfect; Nadthanan Pinchai; Steven Park; David S Perlin; Yohannes G Asfaw; Joseph Heitman; John R Perfect; William J Steinbach Journal: Eukaryot Cell Date: 2008-05-02
Authors: C Lichtenstern; S Swoboda; M Hirschburger; E Domann; T Hoppe-Tichy; M Winkler; C Lass-Flörl; M A Weigand Journal: Anaesthesist Date: 2010-01 Impact factor: 1.041