| Autor: |
Colombo, Arnaldo L., Ngai, Angela L., Bourque, Michael, Bradshaw, Susan K., Strohmaier, Kim M., Taylor, Arlene F., Lupinacci, Robert J., Kartsonis, Nicholas A. |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; May 2010, Vol. 54 Issue: 5 p1864-1871, 8p |
| Abstrakt: |
ABSTRACTIncreasing rates of invasive candidiasis caused by non-albicans Candidaspecies have been reported worldwide. Particular concerns have been raised for C. parapsilosisbecause of reduced in vitrosusceptibility to echinocandins. We identified 212 patients with invasive candidiasis due to non-albicans Candidaspecies (≥5 cases per species) in 5 clinical trials of caspofungin monotherapy from the pharmaceutical sponsor's (Merck and Co., Inc.) database: 71 cases were caused by C. parapsilosis, 65 by C. tropicalis, 54 by C. glabrata, 10 by C. krusei, 9 by C. guilliermondii, and 5 by C. lusitaniae. One hundred sixty-seven cases caused by C. albicanswere also identified. Efficacy was assessed at the end of caspofungin therapy. Success (favorable overall response) required favorable clinical and microbiological responses. The mean APACHE II scores were 16.5 in the non-albicansgroup and 15.7 in the C. albicansgroup. Neutropenia at study entry was more common in the non-albicansgroup (12%) than in the C. albicansgroup (5%). The median duration of caspofungin therapy was 14 days in both groups. The success rates were 77% in both groups and at least 70% for each non-albicansspecies: 74% for C. parapsilosis, 71% for C. tropicalis, 85% for C. glabrata, 70% for C. krusei, 89% for C. guilliermondii, and 100% for C. lusitaniae. The times to negative blood culture were similar for the various species. The overall mortality rates were 26% in the non-albicansgroup and 29% in the C. albicansgroup. Drug-related serious adverse events and discontinuations due to caspofungin toxicity were uncommon. Although the sample sizes were limited, caspofungin demonstrated favorable efficacy and safety profiles in the treatment of invasive candidiasis caused by the following non-albicans Candidaspecies: C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. guilliermondii, and C. lusitaniae. |
| Databáze: |
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