TY - JOUR
T1 - Monotherapy with caspofungin for candidaemia in adult patients with cancer
T2 - a retrospective, single institution study
AU - Sipsas, Nikolaos V.
AU - Lewis, Russell E.
AU - Raad, Issam I.
AU - Kontoyiannis, Dimitrios P.
N1 - Funding Information:
Funding : NVS acknowledges support from the Special Account for Research Funds (ELKE) of the National and Kapodistrian University of Athens, Greece. This study was supported by a research grant from the U.S. Investigator-Initiated Studies Program of Merck & Co., Inc. (to DPK). The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck & Co., Inc.
PY - 2009/7
Y1 - 2009/7
N2 - 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 Candida parapsilosis (21%), Candida tropicalis (16%) and Candida glabrata (10%). In vitro susceptibility studies showed that of 30 Candida isolates tested, only one C. parapsilosis isolate had a caspofungin minimum inhibitory concentration >1 μg/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.
AB - 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 Candida parapsilosis (21%), Candida tropicalis (16%) and Candida glabrata (10%). In vitro susceptibility studies showed that of 30 Candida isolates tested, only one C. parapsilosis isolate had a caspofungin minimum inhibitory concentration >1 μg/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.
KW - Cancer
KW - Candidaemia
KW - Caspofungin
UR - http://www.scopus.com/inward/record.url?scp=67349182880&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67349182880&partnerID=8YFLogxK
U2 - 10.1016/j.ijantimicag.2009.01.006
DO - 10.1016/j.ijantimicag.2009.01.006
M3 - Article
C2 - 19251404
AN - SCOPUS:67349182880
SN - 0924-8579
VL - 34
SP - 95
EP - 98
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 1
ER -