title: Caspofungin for the treatment of azole resistant candidemia in a premature infant.
abstract: Candidemia is common in extremely low birth weight infants and is associated with substantial mortality and morbidity. Treatment options have traditionally been limited to amphotericin B deoxycholate or fluconazole. We present a case of a premature infant with persistent candidemia despite antifungal treatment that responded to therapy with caspofungin, an echinocandin antifungal. The infant's Candida isolate developed resistance to azoles during fluconazole administration and also suffered from severe hypercalcemia during the initiation of caspofungin therapy.
authors.affiliation: Department of Pediatrics, Duke University, Durham, NC 27710, USA. smith466@mc.duke.edu
authors.forename: P B
authors.initials: PB
authors.lastname: Smith
authors.forename: W J
authors.initials: WJ
authors.lastname: Steinbach
authors.forename: C M
authors.initials: CM
authors.lastname: Cotten
authors.forename: W A
authors.initials: WA
authors.lastname: Schell
authors.forename: J R
authors.initials: JR
authors.lastname: Perfect
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: D K
authors.initials: DK
authors.lastname: Benjamin
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy*; D000077336:Caspofungin; D004352:Drug Resistance, Microbial; D054714:Echinocandins; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D055666:Lipopeptides; D008297:Male; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D011743:Pyrimidines / Q000494:pharmacology / Q000627:therapeutic use; D014230:Triazoles / Q000494:pharmacology / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole