Caspofungin for the treatment of immunocompromised and severely ill children and neonates with invasive fungal infections

Abstract

Caspofungin is the first member of the echinocandin class of antifungals to receive an indication for the use in infants, children, and adolescents from the United States Food and Drug Administration. Daily doses of 50 mg/m(2) result in pharmacokinetic parameters that are similar to those observed in adults. Although fewer data are available, the response rates in pediatric patients who received caspofungin either as treatment or empiric therapy in clinical trials are similar to those reported in adults. In addition, caspofungin appears to be generally safe and well tolerated in this population. This represents a significant step forward in the treatment of invasive fungal infections within this population, as caspofungin is associated with few clinically significant drug-interactions and toxicities compared to other antifungals, such as the azoles and amphotericin B.

Keywords: aspergillosis; candidiasis; caspofungin; echinocandins; invasive fungal infections; neonates; pediatrics.

Figure 1

Favorable response rates in children and adolescents compared to adults who received caspofungin either as treatment for invasive or esophageal candidiasis, or as salvage therapy against invasive aspergillosis.