Caspofungin 약물 사용 평가
Drug Use Evaluation of Caspofungin
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초록
Caspofungin is an echinocandin antifungal agent active against Aspergillus, Candida. This study was performed to evaluate the appropriateness of use of caspofungin according to the criteria modified from IDSA (Infectious Disease Society of America) and Korea health insurance guidelines. The study was conducted through retrospective chart review of 67 people, 69 cases of inpatients who received caspofungin in Seoul National University Hospital from January 2008 to August 2010. The use of caspofungin was highly appropriate (93.5%). The initial and maintenance dosage of caspofungin was appropriate in 79.7% of the cases. Duration of therapy was appropriate in 76.8% of patients. Caspofungin has known interactions with HIV medications (efavirenz. nevirapine), phenytoin, dexamethasone, rifampin, carbamazepine, calcineurin inhibitors (cyclosporine,tacrolimus). Drugs coadministered with caspofungin consisted of G-CSF (31 cases), granulocyte infusion (7 cases) phenytoin (1 case), Dexamethasone (1 case), Tacrolimus (5 cases), and Cyclosporine (5 cases). Caspofungin was properly used according to the criteria in 88-100% of cases. Complications occurred in 45 cases, including increasing serum potassium levels (16 cases), hepatotoxicity (13 cases), fever (10 cases) and nausea, vomiting, and diarrhea. At the end of the caspofungin therapy, there were successful outcomes in 56.82% of the patients. The death rate at 7 days after treatment was 20.6%.
Abstract
Caspofungin is an echinocandin antifungal agent active against Aspergillus, Candida. This study was performed to evaluate the appropriateness of use of caspofungin according to the criteria modified from IDSA (Infectious Disease Society of America) and Korea health insurance guidelines. The study was conducted through retrospective chart review of 67 people, 69 cases of inpatients who received caspofungin in Seoul National University Hospital from January 2008 to August 2010. The use of caspofungin was highly appropriate (93.5%). The initial and maintenance dosage of caspofungin was appropriate in 79.7% of the cases. Duration of therapy was appropriate in 76.8% of patients. Caspofungin has known interactions with HIV medications (efavirenz. nevirapine), phenytoin, dexamethasone, rifampin, carbamazepine, calcineurin inhibitors (cyclosporine,tacrolimus). Drugs coadministered with caspofungin consisted of G-CSF (31 cases), granulocyte infusion (7 cases) phenytoin (1 case), Dexamethasone (1 case), Tacrolimus (5 cases), and Cyclosporine (5 cases). Caspofungin was properly used according to the criteria in 88-100% of cases. Complications occurred in 45 cases, including increasing serum potassium levels (16 cases), hepatotoxicity (13 cases), fever (10 cases) and nausea, vomiting, and diarrhea. At the end of the caspofungin therapy, there were successful outcomes in 56.82% of the patients. The death rate at 7 days after treatment was 20.6%.
참고문헌 (12)
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