title: Efficacy of micafungin in invasive candidiasis caused by common Candida species with special emphasis on non-albicans Candida species.
abstract: 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.
authors.affiliation: University of Cologne, Cologne, Germany.
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
authors.forename: Jose
authors.initials: J
authors.lastname: Vazquez
authors.forename: Jan
authors.initials: J
authors.lastname: De Waele
authors.forename: Robert
authors.initials: R
authors.lastname: Betts
authors.forename: Coleman
authors.initials: C
authors.lastname: Rotstein
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
authors.forename: Peter G
authors.initials: PG
authors.lastname: Pappas
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ullmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000009:adverse effects / Q000627:therapeutic use; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy* / Q000382:microbiology; D058365:Candidiasis, Invasive / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D017326:Clinical Trials, Phase III as Topic; D054714:Echinocandins / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D055666:Lipopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D000077551:Micafungin
keywords: C. glabrata; C. parapsilosis; C. tropicalis; Candida albicans; Micafungin; invasive candidiasis