OBJECTIVE: To review our experience of caspofungin in the treatment of persistent candidemia in the neonatal intensive care unit. STUDY DESIGN: This was a retrospective chart review on 13 infants in whom caspofungin was added to conventional antifungals (amphotericin B and/or fluconazole or flucytosine) for the treatment of refractory candidemia. RESULTS: A total of 12 infants were preterm (gestational age, 24 to 28 weeks) and one was term; the median birth weight was 800 g (range, 530 to 5600 g). Candidemia (Candida albicans in five, C. parapsilosis in six, C. albicans and C. parapsilosis in one and C. tropicalis in one) persisted despite 6 to 30 days of conventional antifungal therapy. After the addition of caspofungin, sterilization of blood cultures was achieved in 11 infants at the median time of 3 days (range, 1 to 21 days). Adverse events included thrombophlebitis (one patient), hypokalemia (two patients) and elevation of liver enzymes (four patients). Three infants had a second episode of candidemia and seven patients died. CONCLUSION: Caspofungin may be an efficacious addition for treatment of candidemia refractory to conventional antifungal therapy. This drug should be further investigated in neonates.
OBJECTIVE: To review our experience of caspofungin in the treatment of persistent candidemia in the neonatal intensive care unit. STUDY DESIGN: This was a retrospective chart review on 13 infants in whom caspofungin was added to conventional antifungals (amphotericin B and/or fluconazole or flucytosine) for the treatment of refractory candidemia. RESULTS: A total of 12 infants were preterm (gestational age, 24 to 28 weeks) and one was term; the median birth weight was 800 g (range, 530 to 5600 g). Candidemia (Candida albicans in five, C. parapsilosis in six, C. albicans and C. parapsilosis in one and C. tropicalis in one) persisted despite 6 to 30 days of conventional antifungal therapy. After the addition of caspofungin, sterilization of blood cultures was achieved in 11 infants at the median time of 3 days (range, 1 to 21 days). Adverse events included thrombophlebitis (one patient), hypokalemia (two patients) and elevation of liver enzymes (four patients). Three infants had a second episode of candidemia and seven patients died. CONCLUSION:Caspofungin may be an efficacious addition for treatment of candidemia refractory to conventional antifungal therapy. This drug should be further investigated in neonates.
Authors: Amy M Flattery; Emily Hickey; Charles J Gill; Mary Ann Powles; Andrew S Misura; Andrew M Galgoci; Joan D Ellis; Rena Zhang; Punam Sandhu; John Ronan; George K Abruzzo Journal: Antimicrob Agents Chemother Date: 2011-04-25 Impact factor: 5.191
Authors: A Spiliopoulou; G Dimitriou; E Jelastopulu; I Giannakopoulos; E D Anastassiou; Myrto Christofidou Journal: Mycopathologia Date: 2011-11-11 Impact factor: 2.574
Authors: Xavier Sáez-Llorens; Mercedes Macias; Padmanabha Maiya; Juan Pineros; Hasan S Jafri; Archana Chatterjee; Gloria Ruiz; Janaki Raghavan; Susan K Bradshaw; Nicholas A Kartsonis; Peng Sun; Kim M Strohmaier; Marissa Fallon; Sheng Bi; Julie A Stone; Joseph W Chow Journal: Antimicrob Agents Chemother Date: 2008-12-15 Impact factor: 5.191