Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Caspofungin for the treatment of azole resistant candidemia in a premature infant

Journal of Perinatology volume 27, pages 127–129 (2007)Cite this article

Abstract

Candidemia is common in extremely low birth weight infants and is associated with substantial mortality and morbidity. Treatment options have traditionally been limited to amphotericin B deoxycholate or fluconazole. We present a case of a premature infant with persistent candidemia despite antifungal treatment that responded to therapy with caspofungin, an echinocandin antifungal. The infant's Candida isolate developed resistance to azoles during fluconazole administration and also suffered from severe hypercalcemia during the initiation of caspofungin therapy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 2002; 110: 285–291.

    Article  Google Scholar 

  2. Franklin JA, McCormick J, Flynn PM . Retrospective study of the safety of caspofungin in immunocompromised pediatric patients. Pediatr Infect Dis J 2003; 22: 747–749.

    Article  Google Scholar 

  3. Walsh TJ, Adamson PC, Seibel NL, Flynn PM, Neely MN, Schwartz C et al. Pharmacokinetics, safety, and tolerability of caspofungin in children and adolescents. Antimicrob Agents Chemother 2005; 49: 4536–4545.

    Article  CAS  Google Scholar 

  4. Odio CM, Araya R, Pinto LE, Castro CE, Vasquez S, Alfaro B et al. Caspofungin therapy of neonates with invasive candidiasis. Pediatr Infect Dis J 2004; 23: 1093–1097.

    Google Scholar 

  5. Natarajan G, Lulic-Botica M, Rongkavilit C, Pappas A, Bedard M . Experience with caspofungin in the treatment of persistent fungemia in neonates. J Perinatol 2005; 25: 770–777.

    Article  CAS  Google Scholar 

  6. Kantarjian HM, Saad MF, Estey EH, Sellin RV, Samaan NA . Hypercalcemia in disseminated candidiasis. Am J Med. 1983; 74: 721–724.

    Article  CAS  Google Scholar 

  7. Muller FM, Weig M, Peter J, Walsh TJ . Azole cross-resistance to ketoconazole, fluconazole, itraconazole and voriconazole in clinical Candida albicans isolates from HIV-infected children with oropharyngeal candidosis. J Antimicrob Chemother 2000; 46: 338–340.

    Article  CAS  Google Scholar 

  8. Pfaller MA, Chaturvedi V, Espinel-Ingroff A, Ghannoum MA, Gosey LL, Odds FC et al. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard M27-A2National Committee for Clinical Laboratory Standards. National Committee for Clinical Laboratory Standards: Wayne, Pennsylvania, 2002.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Duke University, Durham, NC, USA

    P B Smith, W J Steinbach, C M Cotten & D K Benjamin Jr

  2. Duke University Clinical Research Institute, Durham, NC, USA

    P B Smith & D K Benjamin Jr

  3. Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, USA

    W J Steinbach & J R Perfect

  4. Department of Medicine, Duke University, Durham, NC, USA

    W A Schell & J R Perfect

  5. National Cancer Institute, Bethesda, MD, USA

    T J Walsh

Authors
  1. P B Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W J Steinbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C M Cotten
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W A Schell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J R Perfect
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T J Walsh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D K Benjamin Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P B Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, P., Steinbach, W., Cotten, C. et al. Caspofungin for the treatment of azole resistant candidemia in a premature infant. J Perinatol 27, 127–129 (2007). https://doi.org/10.1038/sj.jp.7211637

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211637

Keywords

This article is cited by

Search

Advanced search

Quick links