Clinical application of antifungal agents caspofungin and micafungin in patients undergoing hematopoietic stem cell transplantation

OBJECTIVE To investigate the efficacy of caspofungin and micafungin in patients undergoing hematopoietic stem cell transplantation.METHODS The clinical data of HSCT patients received caspofungin and micafungin from Aug.2010 to Jul.2011 were collected.A retrospective analysis was employed to evaluate the efficacy,adverse reactions and utility of caspofungin and micafungin in HSCT patients.RESULTS Totally 31 patients received caspafungin and 49 patients received micafungin were enrolled.There were no statistical difference between the two groups in age,gender,the underlying disease,the type of transplantation and the time of administration.The effective rates of caspofungin and micafungin in the two groups were 68.4% and 83.7% respectively,with no statistical difference;there was statistical difference between the two groups in the incidence of adverse reactions(P0.05).The DUIs of caspofungin and micafungin were 1.050 and 0.983,respectively.The DDC of caspofungin was 2042.6 yuan,and micafungin 1290.4 yuan.CONCLUSION The efficacy of the two types of echinocandin drugs is similar in HSCT patients,but the incidence of adverse reactions in caspofungin group is higher than micafungin.Both DUIs are less or close to 1.0,which are considered as reasonable use.DDC of caspofungin is 1.6 times higher than that of micafungin,suggesting micafungin is superior to micafungin on economical perspective while efficacy and adverse reactions are comparable.