Colombo AL, Ngai AL, Bourque M et al. Antimicrob Agents Chemother 2010;54:1864–71.
In this study, 212 patients with candidiasis caused by non-albicans Candida spp. were identified from five clinical trials of caspofungin monotherapy. The particular species involved were Candida parapsilosis, Candida tropicalis, Candida glabrata, Candida krusei, Candida guilliermondii, and Candida lusitaniae. Response rates to caspofungin therapy were compared with those from trials involving cases of candidiasis caused by Candida albicans were identified. Despite concerns regarding the in vitro susceptibility of the echinocandins against C parapsilosis, the results demonstrated similar outcomes in response to caspofungin treatment among the various Candida spp., including C parapsilosis.
Candida spp. continue to be the most commonly encountered fungal pathogens. Increasing rates of isolation of non-albicans Candida spp. have alarmed some clinicians because of differences in their susceptibility to various antifungal agents, including the echinocandins. Although Candida parapsilosis and Candida guilliermondii have demonstrated reduced in vitro susceptibility to the echinocandins compared with Candida albicans, the clinical significance of this observation has not been defined [1–3]. In an effort to determine the efficacy of caspofungin against non-albicans Candida spp., this retrospective review of five Phase II/III clinical trials of caspofungin monotherapy for candidiasis was performed using information obtained from a Merck & Co., Inc. (North Wales, PA, USA) database.