University of Cologne, Cologne, Germany.
Mycoses. 2014 Feb;57(2):79-89. doi: 10.1111/myc.12104. Epub 2013 Jun 20.
The incidence of invasive candidiasis caused by non-albicans Candida (NAC) spp. is increasing. The aim of this analysis was to evaluate the efficacy of micafungin, caspofungin and liposomal amphotericin B in patients with invasive candidiasis and candidaemia caused by different Candida spp. This post hoc analysis used data obtained from two randomised phase III trials was conducted to evaluate the efficacy and safety of micafungin vs. caspofungin and micafungin vs. liposomal amphotericin B. Treatment success, clinical response, mycological response and mortality were evaluated in patients infected with C. albicans and NAC spp. Treatment success rates in patients with either C. albicans or NAC infections were similar. Outcomes were similar for micafungin, caspofungin and liposomal amphotericin B. Candida albicans was the most prevalent pathogen recovered (41.0%), followed by C. tropicalis (17.9%), C. parapsilosis (14.4%), C. glabrata (10.4%), multiple Candida spp. (7.3%) and C. krusei (3.2%). Age, primary diagnosis (i.e. candidaemia or invasive candidiasis), previous corticosteroid therapy and Acute Physiology and Chronic Health Evaluation II score were identified as potential predictors of treatment success and mortality. Micafungin, caspofungin and liposomal amphotericin B exhibit favourable treatment response rates that are comparable for patients infected with different Candida spp.
非白念珠菌属念珠菌（NAC）引起的侵袭性念珠菌病的发病率正在上升。本分析旨在评估米卡芬净、卡泊芬净和两性霉素 B 脂质体在不同念珠菌属引起的侵袭性念珠菌病和念珠菌血症患者中的疗效。本事后分析使用了两项随机 III 期试验的数据，评估了米卡芬净与卡泊芬净和米卡芬净与两性霉素 B 脂质体的疗效和安全性。评估了感染白色念珠菌和非白念珠菌属念珠菌的患者的治疗成功率、临床反应、真菌学反应和死亡率。白色念珠菌或非白念珠菌属念珠菌感染患者的治疗成功率相似。米卡芬净、卡泊芬净和两性霉素 B 脂质体的结果相似。最常见的病原体是白色念珠菌（41.0%），其次是热带念珠菌（17.9%）、近平滑念珠菌（14.4%）、光滑念珠菌（10.4%）、多种念珠菌属（7.3%）和克柔念珠菌（3.2%）。年龄、主要诊断（即念珠菌血症或侵袭性念珠菌病）、既往皮质类固醇治疗和急性生理学和慢性健康评估 II 评分被确定为治疗成功和死亡率的潜在预测因素。米卡芬净、卡泊芬净和两性霉素 B 脂质体具有良好的治疗反应率，对于感染不同念珠菌属的患者相当。
