https://scholars.lib.ntu.edu.tw/handle/123456789/566540
標題: | A prospective, multicenter study of caspofungin for the treatment of documented candida or aspergillus infections in pediatric patients | 作者: | Zaoutis T.E. Jafri H.S. LI-MIN HUANG Locatelli F. Barzilai A. Ebell W. Steinbach W.J. Bradley J. Lieberman J.M. Hsiao C.-C. Seibel N. Laws H.-J. Gamba M. Petrecz M. Taylor A.F. Strohmaier K.M. Chow J.W. Kartsonis N.A. Ngai A.L. |
關鍵字: | Caspofungin; Echinocandin; Invasive aspergillosis; Invasive candidiasis; Pediatric patients | 公開日期: | 2009 | 卷: | 123 | 期: | 3 | 起(迄)頁: | 877-884 | 來源出版物: | Pediatrics | 摘要: | OBJECTIVE. We evaluated the safety, tolerability, and efficacy of caspofungin in pediatric patients with invasive aspergillosis, invasive candidiasis, or esophageal candidiasis. METHODS. This was a multicenter, prospective, open-label study in children 3 months to 17 years of age with proven or probable invasive aspergillosis, proven invasive candidiasis, or proven esophageal candidiasis. All of the patients received caspofungin 70 mg/m 2 on day 1, followed by 50 mg/m 2 per day (maximum: 70 mg/day), as primary or salvage monotherapy. Favorable response was defined as complete resolution of clinical findings and microbiologic (or radiographic/endoscopic) eradication (complete response) or significant improvement in these parameters (partial response). Efficacy was assessed at the end of caspofungin therapy in patients with a confirmed diagnosis who received ? 1 dose of caspofungin. The primary safety evaluation was the proportion of patients with clinical or laboratory drug-related adverse events. RESULTS. Of the 49 patients enrolled, 3 were < 2 years of age, 30 were 2 to 11 years of age, and 16 were 12 to 17 years of age. Forty-eight patients had confirmed disease: invasive aspergillosis (10), invasive candidiasis (37), and esophageal candidiasis (1). Eight of 10 patients with invasive aspergillosis had pulmonary involvement; 34 of 37 patients with invasive candidiasis had candidemia. Caspofungin was given for 2 to 87 days. Success at end of therapy was achieved in 5 of 10 patients with invasive aspergillosis, 30 of 37 with invasive candidiasis, and 1 of 1 with esophageal candidiasis. One patient (invasive candidiasis) relapsed during the 28-day follow-up period. Drug-related clinical or laboratory adverse events occurred in 27% and 35% of patients, respectively. There were no serious drug-related adverse events or discontinuations of caspofungin because of toxicity. CONCLUSIONS. Caspofungin was generally well tolerated in pediatric patients aged 6 months through 17 years. Efficacy outcomes in patients with invasive aspergillosis or invasive candidiasis were consistent with previous adult studies in these indications. Copyright ? 2009 by the American Academy of Pediatrics. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-63149172257&doi=10.1542%2fpeds.2008-1158&partnerID=40&md5=154b346064896a37a8bc503a7c1470a6 https://scholars.lib.ntu.edu.tw/handle/123456789/566540 |
ISSN: | 0031-4005 | DOI: | 10.1542/peds.2008-1158 | SDG/關鍵字: | amphotericin B; amphotericin B lipid complex; amphotericin plus voriconazole; caspofungin; itraconazole; methylprednisolone; unclassified drug; voriconazole; antifungal agent; caspofungin; echinocandin; adolescent; article; aspergillosis; candidemia; child; child health care; chill; clinical article; clinical trial; continuous infusion; controlled clinical trial; controlled study; drug dose increase; drug efficacy; drug safety; drug tolerability; endoscopy; erythema; esophagus candidiasis; female; fever; follow up; graft versus host reaction; human; hypotension; infant; invasive candidiasis; loading drug dose; maculopapular rash; male; monotherapy; multicenter study; oxygen saturation; pain; priority journal; pruritus; radiodiagnosis; rash; recurrent disease; salvage therapy; side effect; swelling; thrombophlebitis; treatment response; urticaria; aspergillosis; candidiasis; disease course; dose response; drug administration; drug toxicity; esophagus disease; intravenous drug administration; liver function test; lung aspergillosis; opportunistic infection; preschool child; prospective study; treatment outcome; Adolescent; Antifungal Agents; Aspergillosis; Candidiasis; Child; Child, Preschool; Disease Progression; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Toxicity; Echinocandins; Esophageal Diseases; Female; Humans; Infant; Infusions, Intravenous; Liver Function Tests; Male; Opportunistic Infections; Prospective Studies; Pulmonary Aspergillosis; Recurrence; Treatment Outcome |
顯示於: | 醫學系 |
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