Efficacy and safety of caspofungin in critically ill patients. ProCAS Study

Introducción. Caspofungina es una equinocandina con eficacia probada en candidiasis invasiva (CI) y aspergilosis invasiva (AI). ProCAS es un estudio patrocinado por el Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva Critica Y Unidades Coronarias (Semicyuc), que trata de analizar su efectividad y seguridad en condiciones de práctica clínica habitual en el paciente grave ingresado en UCI. Material y métodos. Estudio observacional, prospectivo y multicéntrico que tiene como objetivo estimar la efectividad clínica y la seguridad del acetato de caspofungina en el tratamiento de CI y de AI en pacientes críticos refractarios o intolerantes al tratamiento antifúngico convencional. La valoración de la efectividad tanto clínica como la microbiológica se realizó al final del tratamiento con caspofungina. Resultados. Se incluyeron 98 pacientes; 62 CI probadas, 25 CI probables y 11 AI probables, procedentes de 24 centros, durante los años 2005 y 2006. El tratamiento con caspofungina se realizó en monoterapia en el 89.8% de los casos y como primera línea en el 54.1%. La respuesta clínica favorable obtenida para CI, CI probable y AI probable fue de 91,9%, 84% y 81.8%, respectivamente. La respuesta microbiológica fue favorable en el 74,6%, 68% y 54.6%, para los casos de CI probada, CI probable y AI probable, respectivamente. No se objetivaron efectos adversos graves. Conclusiones. En condiciones de práctica clínica habitual, caspofungina es eficaz y segura para el tratamiento de infecciones fúngicas invasoras (CI/AI). El perfil de eficacia y seguridad fue similar al observado en los ensayos clínicos publicados(AU)

Introduction. Caspofungin is an echinocandin with proven efficacy in invasive candidiasis (IC) and invasive aspergillosis (IA). ProCAS is a study sponsored by the Working Group of the Infectious Diseases of the Spanish Society of Intensive Care Medicine, which analyzes the effectiveness and safety of caspofungin in routine clinical practice conditions in the critically ill. Methods. A prospective, multicenter, observational study designed to estimate the clinical effectiveness and safety of caspofungin acetate in the treatment of IC and IA in patients refractory to or intolerant of conventional antifungal therapy. The assessment of effectiveness both clinic and the microbiological was carried out at the end of the treatment with caspofungin. Results. We included 98 patients, 62 IC proven, 25 probable and 11 IA probable, from 24 centers during 2005 and 2006. Treatment with caspofungin monotherapy was performed in 89.8% of cases and as first line therapy in 54.1%. The favorable clinical response obtained for IC, probable IC, and probable IA was 91.9, 84, and 81.8%, respectively. The microbiological response was favorable in 74.6, 68, and 54.6% for proven cases of IC, probable IC, and probable IA, respectively. No serious adverse effects were observed. Conclusions. In routine clinical practice conditions, caspofungin is effective and safe for the treatment of invasive fungal infections (IC/IA). The efficacy and safety profile was similar to that observed in published clinical trials(AU)

Efficacy and safety of caspofungin in critically ill patients. ProCAS Study.

INTRODUCTION: Caspofungin is an echinocandin with proven efficacy in invasive candidiasis (IC) and invasive aspergillosis (IA). ProCAS is a study sponsored by the Working Group of the Infectious Diseases of the Spanish Society of Intensive Care Medicine, which analyzes the effectiveness and safety of caspofungin in routine clinical practice conditions in the critically ill. METHODS: A prospective, multicenter, observational study designed to estimate the clinical effectiveness and safety of caspofungin acetate in the treatment of IC and IA in patients refractory to or intolerant of conventional antifungal therapy. The assessment of effectiveness both clinic and the microbiological was carried out at the end of the treatment with caspofungin. RESULTS: We included 98 patients, 62 IC proven, 25 probable and 11 IA probable, from 24 centers during 2005 and 2006. Treatment with caspofungin monotherapy was performed in 89.8% of cases and as first line therapy in 54.1%. The favorable clinical response obtained for IC, probable IC, and probable IA was 91.9, 84, and 81.8%, respectively. The microbiological response was favorable in 74.6, 68, and 54.6% for proven cases of IC, probable IC, and probable IA, respectively. No serious adverse effects were observed. CONCLUSIONS: In routine clinical practice conditions, caspofungin is effective and safe for the treatment of invasive fungal infections (IC/IA). The efficacy and safety profile was similar to that observed in published clinical trials.