Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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High-dose caspofungin salvage in a very-low-birth-weight infant with refractory candidemia

극소 저체중 출생아의 난치성 칸디다혈증에서 고용량 Caspofungin 구제요법

  • Seo, Eun Sun (Department of Pediatics, Busan St. Mary's Medical Center) ;
  • Park, Geun Hwa (Department of Pediatics, Busan St. Mary's Medical Center) ;
  • Kim, Sung Mi (Department of Pediatics, Busan St. Mary's Medical Center) ;
  • Jung, Hye An (Department of Radiology, Busan St. Mary's Medical Center) ;
  • Kim, Byoung Kuk (Department of clinical pathology, Busan St. Mary's Medical Center)
  • 서은선 (부산성모병원 소아청소년과) ;
  • 박근화 (부산성모병원 소아청소년과) ;
  • 김성미 (부산성모병원 소아청소년과) ;
  • 정혜안 (부산성모병원 영상의학과) ;
  • 김병국 (부산성모병원 진단검사의학과)
  • Received : 2009.08.12
  • Accepted : 2009.12.12
  • Published : 2010.02.15
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Abstract

Candidiasis is one of the most common causes of late-onset infection among very-low-birth-weight infants (VLBW) in most neonatal intensive care units and is associated with significant morbidity and mortality. Standard therapy consists of the administration of amphotericin B, amphotericin B complex, and fluconazole. In many cases, candidiasis is not easily eradicated, despite the administration of these drugs. We report our experience of the addition of high-dose caspofungin to the conventional antifungal drugs in a VLBW infant with refractory candidemia.

저자들은 고식적인 항진균제에 반응하지 않는 극소 저체중 출생아에서 발생한 지속적인 전신 칸디다증에서 이들 고식적인 항진균제에 고용량의 caspofungin을 병용 투여하여 국내에서 처음으로 특별한 약물 부작용 없이 치유한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Chapman R. Prevention and treatment of candida infection in neonates. Semin Perinatol 2007;31:39-46 https://doi.org/10.1053/j.semperi.2007.01.006
  2. Noyola DE, Fernandez M, Moylett EH, Baker CJ. Ophthalmologic, visceral, and cardiac involvement in neonates with candidemia. Clin Infect Dis 2001;32:1018-23 https://doi.org/10.1086/319601
  3. Natarajan G, Lulic-Botica M. Experience with caspofungin in the treatment of persistent fungemia in neonates. J Perinatol 2005;25:770-7 https://doi.org/10.1038/sj.jp.7211380
  4. Smith PB, Steinbach WJ, Cotten CM. Caspofungin for the treatment of azole resistant candidemia in a premature infant. J Perinatol 2007;27:127-9 https://doi.org/10.1038/sj.jp.7211637
  5. Wey SB, Motomi M, Pfaller MA, Woolson RF, Wenzel RP. Risk factor for hospital acquired candidemia: a matched casecontrol study. Arch Intern Med 1989;149:2349-53 https://doi.org/10.1001/archinte.149.10.2349
  6. Stamos JK, Rowley AH. Candidemia in a pediatric population. Clin Infect Dis 1995;20:571-5
  7. Komshian SV, Uwaydah AK, Sobel JD, Crane LR. Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patients: frequency, characteristics, and evaluation of factors influencing outcome. Rev Infect Dis 1989;11:379-90 https://doi.org/10.1093/clinids/11.3.379
  8. Bross J, Talbot GH, Maislin G, Hurwitz S, Storm BL. Risk factors for nosocomial candidemia: a case control study in adults without leukemia. Am J Med 1989;87:614-20 https://doi.org/10.1016/S0002-9343(89)80392-4
  9. Wey SB, Motomi M, Pfaller MA, Woolson RF, Wenzel RP. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med 1998;148:2642-7 https://doi.org/10.1001/archinte.148.12.2642
  10. Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991;91(3B):72S-75S
  11. Arathoon EG. Clinical efficacy of echinocandin antifungals. Curr Opin Infect Dis 2001;14:685-91
  12. Walsh TJ, Hiemenz JW, Seibel NL. Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases. Clin Infect Dis 1998;26:1383-96 https://doi.org/10.1086/516353
  13. Denning DW. Echinocandin antifungal drugs. Lancet 2003;362:1142-51 https://doi.org/10.1016/S0140-6736(03)14472-8
  14. Tawawa S, Ikeda F, Maki K, Morishita Y, Otomo K, Teratani N, et al. In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi. Antimicro Agents Chemother 2000;44:57-62 https://doi.org/10.1128/AAC.44.1.57-62.2000
  15. Keating GM, Jarvis B. Caspofungin. Drugs 2001;61:1121-9 https://doi.org/10.2165/00003495-200161080-00007
  16. Kartsonis N, Killar J, Mixson L, Hoe CM, Sable C, Bartizal K. Caspofungin susceptibility testing of isolates from patients with esophageal candidiasis or invasive candidiasis: Relationship of MIC to treatment Outcome. Antimicrob Agents Chemother 2005;49;3616-23 https://doi.org/10.1128/AAC.49.9.3616-3623.2005
  17. Villanueva A, Gotuzzo E, Arathoon EG. A randomized double- blind study of caspofugin versus amphotericin for the treatment of candidal esophagitis. Clin Infect Dis 2001;33:1529-35 https://doi.org/10.1086/323401
  18. Odio CM, Araya R, Pinto LE, Castro CE, Vasquez S, Alfro B, et al. Caspofungin therapy of neonates with invasive candidiasis. Pediatr Infect Dis J 2004;23:1093-7
  19. Yalaz M, Akisu M, Hilmioglu S, Calkavur S, Cakmak B, Kultursay N, et al. Successful caspofungin treatment of multidrug resistant Candida parapsilosis septicaemia in an extremely low birth weight neonate. Mycoses 2006;49:242-5 https://doi.org/10.1111/j.1439-0507.2006.01220.x
  20. Walsh TJ, Adamson PC, Seibel NL, Flynn PM, Neely MN, Schwartz C, et al. Pharmacokinetics, safety, and tolerability of caspofungin in children and adolescents. Antimicrob Agents Chemother 2005;49:4536-45 https://doi.org/10.1128/AAC.49.11.4536-4545.2005
  21. Steinbach WJ, Benjamin DK. New antifungal agents under development in children and neonates. Curr Opin Infect Dis 2005;18:484-9 https://doi.org/10.1097/01.qco.0000185986.64759.9a
  22. Clancy CJ, Nguyen MH. Correlation between in vitro susceptibility determined by E test and response to therapy with amphotericin B: results from multicenter prospective study of candidemia. Antimicrob Agents Chemother 1999;43:1289-90

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