Comparative efficacies of the three echinocandins for Candida auris candidemia: real world evidence from a tertiary centre in India.
Med Mycol
; 62(7)2024 Jul 04.
Article
in En
| MEDLINE
| ID: mdl-38918058
ABSTRACT
Though echinocandins are the first line of therapy for C. auris candidemia, there is little clinical data to guide the choice of therapy within this class. This was the first study to compare the three echinocandins in terms of efficacy and outcomes for C. auris candidemia. This was a retrospective analysis of 82 episodes of candidemia caused by C. auris comparing outcomes across the three echinocandins. Majority patients in our study were treated with micafungin. Susceptibility rates were the lowest for caspofungin (35.36% resistance), with no resistance reported for the other two echinocandins. When a susceptible echinocandin was chosen, caspofungin resistance was not a factor significantly associated with mortality. Also, when a susceptible echinocandin was used for therapy, the choice within the class did not affect clinical cure, microbiological cure, or mortality (P > 0.05 for all). Failure to achieve microbiological cure (P = 0.018) and receipt of immune-modulatory therapy (P = 0.01) were significantly associated with increased mortality. Significant cost variation was noted among the echinocandins. Considering the significant cost variation, comparable efficacies can be reassuring for the prescribing physician.
This is the first study comparing efficacy of the three echinocandins in C. auris candidemia. The clinical efficacy of the three echinocandins was found to be comparable. Micafungin and anidulafungin had lower minimum inhibitory concentrations. A significant cost variation was noted.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Microbial Sensitivity Tests
/
Echinocandins
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Candidemia
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Tertiary Care Centers
/
Caspofungin
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Micafungin
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Antifungal Agents
Limits:
Adolescent
/
Adult
/
Aged
/
Female
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Humans
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Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Med Mycol
/
Med. mycol
/
Medical mycology
Journal subject:
MEDICINA VETERINARIA
/
MICROBIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
India
Country of publication:
Reino Unido