Evaluation of Therapeutic Efficacy and Safety of Caspofungin in the Treatment of Severe Invasive Pulmonary Fungal Infection

OBJECTIVE:To investigate therapeutic efficacy and safety of caspofungin in the treatment of severe invasive pulmonary fungal infection (IPFI). METHODS: The clinical data of 18 cases of severe IPFI treated by caspofungin (the duration was up to 5 days) between Apr. 2008 and Sept. 2010 were retrospectively analyzed. The patients were treated with caspofungin in a dose of 70 mg at the first day, and then 50 mg·d-1 or 35 mg·d-1 according to liver function classification Child-Pugh score. Lung’s image, liver and kidney function were monitored during treatment. RESULTS: There were 14 probable cases and 4 possible cases. The overall effective rate was 72.22%(13/18). The treatment duration of effective group was longer than that of ineffective group (21.55±6.91)d vs.(10.00±3.50)d,P0.05). The effective rate of preemptive/empirical therapy group was higher than that of goal/rescue therapy group(91.67% vs. 33.33%,P0.05). It is delayed obviously to improve lung’s image in effective group. No significant adverse drug reaction was found during treatment. CONCLUSION: Caspofungin is effective drug for critical patients with severe IPFI. Preemptive therapy may improve therapeutic efficacy.