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Pharmacotherapy. 2008 Jan;28(1):64-73.

Early clinical experience with anidulafungin at a large tertiary care medical center.

Author information

1
Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.

Abstract

STUDY OBJECTIVE:

To evaluate early clinical experience with anidulafungin.

DESIGN:

Retrospective cohort study.

SETTING:

Large, university-affiliated, tertiary care medical center.

PATIENTS:

All patients receiving anidulafungin between July 15, 2006, and January 15, 2007.

MEASUREMENTS AND MAIN RESULTS:

Thirty-five patients received at least one dose of anidulafungin. Safety and tolerability were evaluated in all patients; efficacy outcomes were assessed in 13 patients who had a documented fungal infection and received anidulafungin for a minimum of 5 days. Common conditions at baseline were hepatic dysfunction (25 patients [71%]), severe sepsis (17 patients [49%]), and solid organ or hematopoietic stem cell transplantation (10 patients [29%]). Eight patients (23%) were receiving drugs with the potential to interact with echinocandins other than anidulafungin. Seventeen (49%) of the 35 patients received anidulafungin as empiric antifungal therapy. Anidulafungin was used to treat invasive candidiasis in seven patients (20%) and candidemia in 10 patients (29%); Candida albicans or Candida glabrata was isolated most frequently in these two infections combined (7 isolates each [41%]/17 infections). A favorable efficacy outcome was noted in 10 (77%) of 13 evaluable patients. One patient developed breakthrough Candida parapsilosis fungemia while receiving anidulafungin. Overall, anidulafungin was well tolerated, with only one patient having an infusion- related reaction. Anidulafungin was also well tolerated among patients receiving concomitant metronidazole.

CONCLUSION:

Anidulafungin was well tolerated and produced favorable outcomes in the majority of the patients evaluated. The availability of anidulafungin makes it a feasible option for antifungal therapy, particularly in patients who have hepatic dysfunction and in those who are receiving drugs than can interact with other echinocandins.

PMID:
18154476
DOI:
10.1592/phco.28.1.64
[Indexed for MEDLINE]

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