title: Efficacy and safety of caspofungin in critically ill patients. ProCAS Study.
abstract: BACKGROUND
  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.
authors.affiliation: Critical Care Unit and Emergency Room, Hospital Universitario de Valme, Seville, Spain. cleong@telefonica.net
authors.forename: Cristóbal
authors.initials: C
authors.lastname: León-Gil
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ubeda-Iglesias
authors.forename: Ana
authors.initials: A
authors.lastname: Loza-Vázquez
authors.forename: María Victoria
authors.initials: MV
authors.lastname: de la Torre
authors.forename: Juan M
authors.initials: JM
authors.lastname: Raurich-Puigdevall
authors.forename: Bernabé
authors.initials: B
authors.lastname: Alvarez-Sánchez
authors.forename: Carlos
authors.initials: C
authors.lastname: Ortiz-Leyva
authors.forename: José María
authors.initials: JM
authors.lastname: Domínguez-Roldán
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Socías-Crespi
authors.forename: José
authors.initials: J
authors.lastname: Garnacho-Montero
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D058365:Candidiasis, Invasive / Q000188:drug therapy*; D000077336:Caspofungin; D055499:Catheter-Related Infections / Q000188:drug therapy; D015897:Comorbidity; D016638:Critical Illness; D003428:Cross Infection / Q000188:drug therapy*; D025141:Drug Resistance, Fungal; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin