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Migoya E, Mistry GC, Stone JA, Comisar W, Sun P, Norcross A, Bi S, Winchell GA, Ghosh K, Uemera N, Deutsch PJ, Wagner JA (Source: The Aspergillus Website – articles)

Abstract  In a non-comparative study, Caspofungin was effective salvage therapy for approximately half of the patients refractory to
or intolerant of standard antifungal agents for invasive aspergillosis. To establish a frame of reference for these results,
we compared the response to Caspofungin with responses to other antifungal agents in a historical cohort of similar patients.
The efficacy could be evaluated in 83 patients who received Caspofungin 50 mg daily after a 70-mg loading dose. The historical
control group, identified through a retrospective review of medical records, included 214 evaluable patients possibly refractory
…

Authors: Ojeda-Uribe M, Herbrecht R, Kiefer MH, Schultz P, Chain J, Chenard MP, Servant JM, Debry C
A rare case of oromandibular Rhizopus oryzae infection is described in a 55-year-old woman with acute myeloid leukaemia and decompensated diabetes mellitus. The infection developed during induction chemotherapy when the patient was neutropenic. She was treated with a combination of amphotericin B lipid formulation and Caspofungin plus surgery. Debridement surgery included excision of the lower lip, chin, floor of the mouth, a portion of the tongue, as well as mandibular …

This study evaluated the safety, tolerability, and pharmacokinetics of single 150- and 210-mg doses of Caspofungin in 16 healthy participants and 100 mg/d for 21 days in 20 healthy participants. Other than infusion site reactions and 1 reversible elevation in alanine aminotransferase (>/=2x and <4x upper limit of normal), Caspofungin was generally well tolerated. Geometric mean AUC0-infinity after single 150- and 210-mg doses was 279.7 and 374.9 mug.h/mL, respectively; peak concentrations were 29.4 and 33.5 mug/mL, respectively; and 24-hour postdose concentrations were 2.8 and 4.2 mug/mL, respectively. Steady state was …

In vitro and in vivo studies suggested that combination of lipid formulation of amphotericin B (L-AMB) and echinocandins may have a synergistic or additive effect against Aspergillus. Furthermore, clinical studies suggested that this combination may improve response of invasive aspergillosis (IA).Between August 1993 and June 2008, the authors identified a total of 159 patients with hematological malignancies who received salvage therapy for IA, with L-AMB alone, echinocandins alone, or a combination of L-AMB and echinocandins. Clinical characteristics, response to salvage therapy, and death up to 12 weeks after initiation of …

(Source: Reactions)

Updated Date: Jul 20, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

This study is a retrospective analysis of death, adverse events (AE), fungal infections, and hepatic function among recipients of liver transplantation at high risk of fungal infection who received prophylactic treatment with Caspofungin. After reviewing data of 105 patients who had received isolated liver transplant between January 2003 and April 2007, we identified and analyzed 82 high-risk patients. Post-transplant patients at high risk for fungal infection are commonly defined by the presence of at least one of the following: (i) re-transplantation; (ii) re-operation; (iii) renal dysfunction. However, in our practice, …

Conclusions
Non-albicans Candida species accounted for the majority of IC in Caspofungin-treated patients. Improved outcomes were observed for patients initiated with Caspofungin within 72 h of positive culture compared with those who received delayed therapy. (Source: Journal of Antimicrobial Chemotherapy)

Authors: Olson JA, George A, Constable D, Smith P, Proffitt RT, Adler-Moore JP
Monotherapy and combination therapy were compared using optimal doses of liposomal amphotericin B, micafungin or Caspofungin in Aspergillus fumigatus pulmonary and disseminated infections. Mice were challenged intravenously (2.8-5.7 x 10(4)) or intranasally (5.8 x 10(7)) with A. fumigatus conidia. Drugs (5, 10 or 15mg/kg) were given for 3 or 6 days as single, concomitant or sequential therapy (i.e. d1-3 and then d4-6). Mice were monitored for survival and tissues were assayed for fungal burden …