Monotherapy with caspofungin for candidaemia in adult patients with cancer: a retrospective, single institution study.
Int J Antimicrob Agents
; 34(1): 95-8, 2009 Jul.
Article
em En
| MEDLINE
| ID: mdl-19251404
ABSTRACT
This study was performed to evaluate retrospectively the efficacy and safety of caspofungin monotherapy for candidaemia in patients with cancer. The medical records were reviewed of 63 consecutive adult patients with cancer who had candidaemia treated with caspofungin alone for at least 3 consecutive days at The University of Texas M.D. Anderson Cancer Center (March 2001-February 2007). Twenty patients (32%) had haematological malignancies. Most of the candidaemia cases (54%) were caused by non-albicans Candida spp. The most frequent isolates were C. albicans (38%) followed by Candidaparapsilosis (21%), Candidatropicalis (16%) and Candidaglabrata (10%). In vitro susceptibility studies showed that of 30 Candida isolates tested, only one C. parapsilosis isolate had a caspofungin minimum inhibitory concentration > 1 microg/mL. The clinical and mycological response rates after 7 days of treatment with caspofungin were 78% and 77%, respectively. The overall mortality rate was 5% on Day 7, 12% on Day 14 and 21% on Day 30. The 30-day Candida-attributable mortality rate was 11% and was significantly higher in patients with fluconazole-resistant or susceptible-dose-dependent Candida isolates. Caspofungin was well tolerated in all patients. Although selection of candidaemic patients with cancer who received caspofungin monotherapy may have accounted for the favourable outcomes, it was observed that caspofungin had efficacy and safety comparable with those in candidaemic patients without malignancy.
Texto completo:
1
Base de dados:
MEDLINE
Métodos Terapêuticos e Terapias MTCI:
Plantas_medicinales
Assunto principal:
Candidíase
/
Fungemia
/
Equinocandinas
/
Antifúngicos
/
Neoplasias
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Int J Antimicrob Agents
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos