Document Detail


The use of caspofungin in extremely low birth weight preterm infants based on clinical trials and reports considering the own experience (case report).
MedLine Citation:
PMID:  25182262     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In recent years, despite of significant progress in the treatment of premature infants with extremely low body weight, still a significant problem remains severe, treatment-resistant generalized infections among which the percentage of fungal infections is increasing. The invasive candidiasis, especially caused by non-albicans species of Candida, are of particular importance. In the case of resistance on fluconazole and amphotericin B the use of echinocandin drug may be a useful choice. This paper reviews the pharmacokinetics of caspofungin in neonates and children, as well as the case reports and clinical trials on the use of caspofungin in neonates, including the premature infants. We describe also the premature neonate with low birth weight and a generalized infection caused by Candida glabrata, where, despite of the treatment based on the sensitivity of the fungus it did not achieve clinical improvement and sterilization of cultures. It was not until the lead-in of caspofungin in dose 2 mg/kg/day allowed to cure the patient. There was a transient increase in the activity of aminotransferases and level of bilirubin as a complication of treatment. At the end of application of caspofungin the liver functions have been slowly normalized. Caspofungin appeared to be effective in the treatment of systemic fungal C. glabrata in premature neonate with extremely low birth weight. Echinocandins, including caspofungin, appear to be a promising alternative to previously used agents in the treatment of invasive Candida infections in newborns. However, the further randomized trials on the use of caspofungin in preterm neonates, regarding long term follow-up, should be undertaken.
Authors:
Krzysztof Stempniewicz; Wojciech Walas; Edyta Gregorek-Pełka; Ewa Kamińska
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Developmental period medicine     Volume:  18     ISSN:  1428-345X     ISO Abbreviation:  Dev Period Med     Publication Date:  2014  
Date Detail:
Created Date:  2014-9-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101636421     Medline TA:  Dev Period Med     Country:  -    
Other Details:
Languages:  POL     Pagination:  221-227     Citation Subset:  -    
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