Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy

Johan Maertens, Issam Raad, George Petrikkos, Marc Boogaerts, Dominik Selleslag, Finn B. Petersen, Carole A. Sable, Nicholas A. Kartsonis, Angela Ngai, Arlene Taylor, Thomas F. Patterson, David W. Denning, Thomas J. Walsh

Producción científica: Articlerevisión exhaustiva

612 Citas (Scopus)

Resumen

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 ≥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.

Idioma originalEnglish (US)
Páginas (desde-hasta)1563-1571
Número de páginas9
PublicaciónClinical Infectious Diseases
Volumen39
N.º11
DOI
EstadoPublished - dic 1 2004

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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