Efficacy of micafungin in invasive candidiasis caused by common Candida species with special emphasis on non-albicans Candida species.

Abstract

The incidence of invasive candidiasis caused by non-albicans Candida (NAC) spp. is increasing. The aim of this analysis was to evaluate the efficacy of micafungin, caspofungin and liposomal amphotericin B in patients with invasive candidiasis and candidaemia caused by different Candida spp. This post hoc analysis used data obtained from two randomised phase III trials was conducted to evaluate the efficacy and safety of micafungin vs. caspofungin and micafungin vs. liposomal amphotericin B. Treatment success, clinical response, mycological response and mortality were evaluated in patients infected with C. albicans and NAC spp. Treatment success rates in patients with either C. albicans or NAC infections were similar. Outcomes were similar for micafungin, caspofungin and liposomal amphotericin B. Candida albicans was the most prevalent pathogen recovered (41.0%), followed by C. tropicalis (17.9%), C. parapsilosis (14.4%), C. glabrata (10.4%), multiple Candida spp. (7.3%) and C. krusei (3.2%). Age, primary diagnosis (i.e. candidaemia or invasive candidiasis), previous corticosteroid therapy and Acute Physiology and Chronic Health Evaluation II score were identified as potential predictors of treatment success and mortality. Micafungin, caspofungin and liposomal amphotericin B exhibit favourable treatment response rates that are comparable for patients infected with different Candida spp.

• Authors: Oliver A Cornely, Jose Vazquez, Jan De Waele, Robert Betts, Coleman Rotstein, Marcio Nucci, Peter G Pappas, Andrew J Ullmann
• Journal: Mycoses (Mycoses) Vol. 57 Issue 2 Pg. 79-89 (Feb 2014) ISSN: 1439-0507 [Electronic] Germany
• PMID: 23786573 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 Blackwell Verlag GmbH.

Chemical References

• Antifungal Agents
• Echinocandins
• Lipopeptides
• liposomal amphotericin B
• Amphotericin B
• Caspofungin
• Micafungin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Amphotericin B (adverse effects, therapeutic use)
• Antifungal Agents (adverse effects, therapeutic use)
• Candida (classification, isolation & purification)
• Candidemia (drug therapy, microbiology)
• Candidiasis, Invasive (drug therapy, microbiology)
• Caspofungin
• Clinical Trials, Phase III as Topic
• Echinocandins (adverse effects, therapeutic use)
• Female
• Humans
• Lipopeptides (adverse effects, therapeutic use)
• Male
• Micafungin
• Middle Aged
• Survival Analysis
• Treatment Outcome
• Young Adult