Evaluation of efficacy and safety of caspofungin on treatment of invasive fungal infections in critical patients

OBJECTIVE To investigate efficacy and safety of caspofungin therapy in critical patients with invasive fungal infection(IFI).METHODS The clinical data of 21 cases critical patients with IFI treated by caspofungin(the duration was up to 5 days) between Apr 2008 and Sep 2010 were retrospectively analyzed.The patients were treated with caspofungin in a dose of 70 mg in the first day,and then 50 mg/d or 35 mg/d according to liver function classification Child-Pugh score.Lung′s image,liver and kidney function were monitored during treatment.RESULTS There were 3 proven cases(blood IFI),14 probable cases and 4 possible cases(pulmonary IFI).The overall effective rate was 71.43%.The average duration of the caspofungin therapy of the effective group was longer than that of ineffective group(21.67±6.88 vs 12.40±5.70 P0.05).The effective rate of preemptive/empirical therapy group was higher than that of goal/rescue therapy group(91.67% vs 44.44%,P0.05).No drug-related side effect was found during treatment.CONCLUSION Caspofungin is an effective and safe antifungal drug for critical patients with IFI.Preemptive therapy may improve the curative effect.