Is caspofungin really an effective treatment for Pneumocystis jirovecii pneumonia in immunocompromised patients without human immunodeficiency virus infection? Experiences at a single center and a literature review

Scand J Infect Dis. 2013 Jun;45(6):484-8. doi: 10.3109/00365548.2012.760842. Epub 2013 Jan 15.

Abstract

Caspofungin, an antifungal agent that acts on the cell wall by inhibiting β-1,3-glucan synthesis, is likely to be effective for treating Pneumocystis pneumonia, because one of the identifying characteristics of Pneumocystis jirovecii is the presence of β-1,3-glucan in its cell wall. Previous case reports in which the efficacy of caspofungin was found to be favourable have supported this hypothesis. However, of 4 HIV-negative patients who received caspofungin as a salvage regimen at Asan Medical Center, none showed a response. Our negative experience opposes the optimistic view of caspofungin use for Pneumocystis pneumonia expressed in previous reports.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Antifungal Agents / therapeutic use*
  • Caspofungin
  • Child, Preschool
  • Echinocandins / therapeutic use*
  • Female
  • Humans
  • Infant
  • Lipopeptides
  • Male
  • Middle Aged
  • Pneumonia, Pneumocystis / drug therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin