Abstract | BACKGROUND: POPULATION AND METHODS: The population consisted of 1 term and 9 premature neonates with invasive candidiasis caused by Candida albicans (n = 4), Candida parapsilosis (n = 3), Candida tropicalis (n = 2) and Candida glabrata (n = 1). Despite initial therapy with deoxycholate amphotericin B, blood cultures remained positive in all patients for 13-49 days. Invasive candidiasis progressed to meningitis and enlarging renal Candida bezoars in the kidney of one patient and an enlarging atrial vegetation in another. Another patient developed severe hypokalemia refractory to potassium supplementation. Two of the C. albicans and all of the non-albicans Candida isolates were resistant to fluconazole; the C. glabrata isolate was resistant to amphotericin B. Amphotericin B was discontinued and caspofungin initiated in all patients in a dosage of 1 mg/kg/d for 2 days followed by 2 mg/kg/d. RESULTS: All positive blood cultures cleared between 3 and 7 days after initiation of caspofungin, the atrial vegetation resolved and the renal Candida bezoars disappeared. Renal and hepatic function tests did not show any values above normal throughout caspofungin therapy. There were no attributable clinical adverse events during the administration of caspofungin in any of the patients. CONCLUSIONS:
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Authors | Carla M Odio, Roberto Araya, Luis E Pinto, Carlos E Castro, Sergio Vasquez, Braulio Alfaro, Alberto Sàenz, Marco L Herrera, Thomas J Walsh |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 23
Issue 12
Pg. 1093-7
(Dec 2004)
ISSN: 0891-3668 [Print] United States |
PMID | 15626944
(Publication Type: Journal Article)
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Chemical References |
- Antifungal Agents
- Echinocandins
- Lipopeptides
- Peptides, Cyclic
- Caspofungin
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Topics |
- Antifungal Agents
(therapeutic use)
- Candida
(drug effects, isolation & purification)
- Candidiasis
(drug therapy, microbiology)
- Caspofungin
- Drug Resistance, Fungal
- Echinocandins
- Humans
- Infant, Newborn
- Infant, Premature
- Lipopeptides
- Microbial Sensitivity Tests
- Peptides, Cyclic
(adverse effects, therapeutic use)
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