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Caspofungin: in pediatric patients with fungal infections

Karly P Garnock-Jones1, Susan J Keam

  • 1Wolters Kluwer Health mid R: Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Philadelphia, Pennsylvania, USA. demail@adis.co.nz

Paediatric Drugs
|July 2, 2009
PubMed

Insights

Caspofungin, an echinocandin, effectively treats pediatric fungal infections by disrupting cell walls. It showed positive results in empirical therapy and various invasive fungal infections, with good tolerability.

Area of Science:

  • Mycology
  • Pharmacology
  • Pediatric Medicine

Background:

  • Caspofungin is the first echinocandin approved for pediatric fungal infections.
  • It functions by inhibiting fungal cell-wall synthesis.
  • Activity varies in vitro, being fungicidal against Candida and fungistatic against Aspergillus.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of caspofungin in pediatric patients.
  • To assess its use in empirical antifungal therapy for febrile neutropenia.
  • To determine its effectiveness in treating established invasive fungal infections.

Main Methods:

  • Randomized, double-blind trial comparing caspofungin to liposomal amphotericin B for empirical therapy.
  • Noncomparative, open-label trial for treating invasive candidiasis, aspergillosis, and esophageal candidiasis.
  • Safety and adverse event monitoring in all pediatric trial participants.

Main Results:

  • 46% of caspofungin recipients showed a favorable response in empirical therapy versus 32% for liposomal amphotericin B.
  • Positive treatment responses were observed in 30/37 with invasive candidiasis, 5/10 with invasive aspergillosis, and 1/1 with esophageal candidiasis.
  • Caspofungin was generally well tolerated, with few serious drug-related adverse events or discontinuations.

Conclusions:

  • Caspofungin is an effective and well-tolerated treatment option for fungal infections in pediatric patients.
  • It demonstrates efficacy in both empirical settings and for specific invasive fungal infections.
  • Its favorable safety profile supports its use in pediatric populations.

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