Prospective, multicentre study of caspofungin for treatment of documented fungal infections in paediatric patients
Abstract number: P1020
Zaoutis T., Jafri H., Huang L., Locatelli F., Barzilai A., Ebell W., Steinbach W., Bradley J., Lieberman J., Hsiao C., Seibel N., Laws H., Petrecz M., Taylor A., Chow J., Kartsonis N., Ngai A.
Objective: A prospective open-label study was performed to obtain data on the efficacy & safety of caspofungin (CAS) in paediatric patients (ped pts) with invasive candidiasis (IC), oesophageal candidiasis (EC), or invasive aspergillosis (IA).
Methods: Ped pts ages 3 mos-17 yrs with proven IC, proven EC, or proven/probable IA (EORTC/MSG criteria) received CAS at 50 mg/m2 daily (70 mg/m2 on Day 1) as either primary or salvage monotreatment (max 70 mg/day). Favourable responses required complete resolution of clinical findings & microbiological (or radiographic/endoscopic) eradication (complete response) or significant improvement in these parameters (partial response). The primary efficacy assessment was at end of CAS treatment (EOT) and included pts with a confirmed diagnosis and receipt of atleast 1 dose of CAS.
Results: Of the 49 pts (33 at 6 mos-11 yrs & 16 at 1217 yrs) enrolled, 48 had confirmed disease: 37 IC, 1 EC, & 10 IA. Most IC pts (35/37) had candidaemia & received CAS as primary treatment (31/37). Most pts with IA had pulmonary involvement (8/10, including 2 with >1 site of infection). All pts with IA were refractory & received CAS as salvage treatment. CAS was dosed for 287 days (median 10 & 38 days for IC & IA, respectively). Success at EOT was 30/37 (81%) in IC, 1/1 in EC, & 5/10 (50%) in IA. IC outcomes were generally similar across Candida spp. No pt developed a serious drug-related adverse event or discontinued CAS due to toxicity. All-cause mortality during treatment or the 4-week posttreatment follow up period was 10%.
Conclusions: In this study, CAS was effective & generally well tolerated in peds pts with IA or IC. Outcomes in peds pts are consistent with those reported in adults.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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