卡泊芬净在重症患者中的疗效与安全性。ProCAS研究。

Efficacy and safety of caspofungin in critically ill patients. ProCAS Study.

作者信息

León-Gil Cristóbal, Ubeda-Iglesias Alejandro, Loza-Vázquez Ana, de la Torre María Victoria, Raurich-Puigdevall Juan M, Alvarez-Sánchez Bernabé, Ortiz-Leyva Carlos, Domínguez-Roldán José María, Socías-Crespi Lorenzo, Garnacho-Montero José

机构信息

Critical Care Unit and Emergency Room, Hospital Universitario de Valme, Seville, Spain.

出版信息

Rev Esp Quimioter. 2012 Dec;25(4):274-82.

PMID:23303260

Abstract

INTRODUCTION

Caspofungin is an echinocandin with proven efficacy in invasive candidiasis (IC) and invasive aspergillosis (IA). ProCAS is a study sponsored by the Working Group of the Infectious Diseases of the Spanish Society of Intensive Care Medicine, which analyzes the effectiveness and safety of caspofungin in routine clinical practice conditions in the critically ill.

METHODS

A prospective, multicenter, observational study designed to estimate the clinical effectiveness and safety of caspofungin acetate in the treatment of IC and IA in patients refractory to or intolerant of conventional antifungal therapy. The assessment of effectiveness both clinic and the microbiological was carried out at the end of the treatment with caspofungin.

RESULTS

We included 98 patients, 62 IC proven, 25 probable and 11 IA probable, from 24 centers during 2005 and 2006. Treatment with caspofungin monotherapy was performed in 89.8% of cases and as first line therapy in 54.1%. The favorable clinical response obtained for IC, probable IC, and probable IA was 91.9, 84, and 81.8%, respectively. The microbiological response was favorable in 74.6, 68, and 54.6% for proven cases of IC, probable IC, and probable IA, respectively. No serious adverse effects were observed.

CONCLUSIONS

In routine clinical practice conditions, caspofungin is effective and safe for the treatment of invasive fungal infections (IC/IA). The efficacy and safety profile was similar to that observed in published clinical trials.

摘要

引言

卡泊芬净是一种棘白菌素，已证实对侵袭性念珠菌病（IC）和侵袭性曲霉病（IA）有效。ProCAS研究由西班牙重症监护医学学会传染病工作组赞助，分析了卡泊芬净在重症患者常规临床实践条件下的有效性和安全性。

方法

一项前瞻性、多中心、观察性研究，旨在评估醋酸卡泊芬净治疗对传统抗真菌治疗难治或不耐受的IC和IA患者的临床有效性和安全性。在卡泊芬净治疗结束时进行临床和微生物学有效性评估。

结果

2005年至2006年期间，我们纳入了来自24个中心的98例患者，其中62例确诊为IC，25例可能为IC，11例可能为IA。89.8%的病例采用卡泊芬净单药治疗，54.1%作为一线治疗。确诊IC、可能的IC和可能的IA的良好临床反应率分别为91.9%、84%和81.8%。确诊IC、可能的IC和可能的IA病例的微生物学反应良好率分别为74.6%、68%和54.6%。未观察到严重不良反应。