Safety and efficacy of non-reduced use of caspofungin in patients with Child-Pugh B or C cirrhosis: a real-world study

作者全名："Yuan, Shi-Dan; Wen, Ke-Li; Cao, Yun-Xing; Huang, Wen-Qi; Zhang, An"

作者地址："[Yuan, Shi-Dan; Wen, Ke-Li; Cao, Yun-Xing; Huang, Wen-Qi; Zhang, An] Chongqing Med Univ, Dept Crit Care Med, Affiliated Hosp 2, 76 Linjiang Rd, Chongqing 400016, Peoples R China"

通信作者："Zhang, A (通讯作者)，Chongqing Med Univ, Dept Crit Care Med, Affiliated Hosp 2, 76 Linjiang Rd, Chongqing 400016, Peoples R China."

来源：INFECTION

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001147827900001

JCR分区：Q1

影响因子：7.5

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Caspofungin; Cirrhosis; Efficacy; Fungal infection; Safety

摘要："Background and purposeThe need for dose adjustment of caspofungin in patients with hepatic impairment is controversial, especially for those with Child-Pugh B or C cirrhosis. The purpose of this study was to investigate the safety and efficacy of standard-dose caspofungin administration in Child-Pugh B and C cirrhotic patients in a real-world clinical setting.Patients and methodsThe electronic medical records of 258 cirrhotic patients, including 67 Child-Pugh B patients and 191 Child-Pugh C patients, who were treated with standard-dose of caspofungin at the Second Affiliated Hospital of Chongqing Medical University, China, from March 2018 to June 2023 were reviewed retrospectively. The white blood cells (WBC), hepatic, renal and coagulation function results before administration and post administration on days 7, 14 and 21 were collected, and the efficacy was assessed in all patients at the end of caspofungin therapy.ResultsFavorable responses were achieved in 137 (53.1%) patients while 34 (13.2%) patients died. We observed that some patients experienced an increase of prothrombin time (PT) or international normalized ratio (INR), or a decrease of WBC, but no exacerbation of hepatic or renal dysfunction were identified and no patient required dose interruption or adjustment because of an adverse drug reaction during treatment with caspofungin.ConclusionsStandard-dose of caspofungin can be safely and effectively used in patients with Child-Pugh B or C cirrhosis, and we appealed to re-assess the most suitable dosing regimen in this population to avoid a potential subtherapeutic exposure."

基金机构：China Health Promotion Foundation

基金资助正文：No Statement Available