Evaluation of caspofungin or micafungin as empiric antifungal therapy in adult patients with persistent febrile neutropenia: A retrospective, observational, sequential cohort analysis

Abstract Background: Caspofungin is approved in the United States for empiric antifungal therapy for persistent febrile neutropenia (FN). There are limited data about the use of other echinocandins in this setting. Objective: After a formulary change, we retrospectively evaluated the safety and effe...

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Bibliographic Details
Published in:Clinical therapeutics 2010-04, Vol.32 (4), p.637-648
Main Authors: Kubiak, David W., PharmD, Bryar, Julie M., BA, McDonnell, Anne M., PharmD, Delgado-Flores, Jorge O., PharmD, Mui, Emily, PharmD, Baden, Lindsey R., MD, Marty, Francisco M
Format: Article
Language:English
Subjects:
Adult
Aged
Antifungal Agents - administration & dosage
Antifungal Agents - adverse effects
Antifungal Agents - therapeutic use
Antimicrobial agents
Biological and medical sciences
Cancer therapies
caspofungin
Cohort Studies
Drug Administration Schedule
echinocandins
Echinocandins - administration & dosage
Echinocandins - adverse effects
Echinocandins - therapeutic use
Epidemiology
febrile neutropenia
Female
Fever
Fever - etiology
Fungal infections
Hematologic and hematopoietic diseases
hematologic malignancy
Hospitals
Humans
Infectious diseases
Internal Medicine
invasive fungal disease
Lipopeptides - administration & dosage
Lipopeptides - adverse effects
Lipopeptides - therapeutic use
Male
Medical Education
Medical sciences
micafungin
Middle Aged
Mycoses - prevention & control
Neutropenia
Neutropenia - drug therapy
Neutropenia - etiology
Other diseases. Hematologic involvement in other diseases
Pharmacokinetics
Pharmacology. Drug treatments
Retrospective Studies
Womens health
Young Adult
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Summary:Abstract Background: Caspofungin is approved in the United States for empiric antifungal therapy for persistent febrile neutropenia (FN). There are limited data about the use of other echinocandins in this setting. Objective: After a formulary change, we retrospectively evaluated the safety and effectiveness of caspofungin and micafungin as empiric antifungal therapy for FN at Brigham and Women's Hospital (Boston, Massachusetts). Methods: This was a retrospective, observational, sequential cohort study. We identified patients who had received ≥2 doses on concurrent days of either caspofungin (between November 2005 and October 2006) or micafungin (between November 2006 and October 2007) for empiric FN therapy. Patients were included for analysis if they were neutropenic (absolute neutrophil count
ISSN:0149-2918
1879-114X
DOI:10.1016/j.clinthera.2010.04.005