A Randomized Double‐Blind Study of Caspofungin versus Amphotericin for the Treatment of Candidal Esophagitis
Abstract
Caspofungin is a new broad-spectrum antifungal drug. A multicenter, double-blind, randomized trial was conducted to assess the efficacy, safety, and tolerability of caspofungin relative to amphotericin B in adults with endoscopically documented symptomatic Candida esophagitis. By use of a modified intent-to-treat analysis, endoscopically verified clinical success was achieved in 74% (95% confidence interval [CI], 59%-86%) and 89% (95% CI, 72%-98%) of patients receiving caspofungin at 50 and 70 mg/day, respectively, and in 63% (95% CI, 49%-76%) of patients given amphotericin B at 0.5 mg/kg/day. Therapy was stopped because of drug-related adverse events in 24% of patients in the amphotericin B group and 4% and 7%, respectively, for the caspofungin groups. This report provides the first demonstration of clinical utility for an echinocandin compound. Caspofungin appeared in this study to be as effective as and better tolerated than amphotericin B for the treatment of esophageal candidiasis.
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Caspofungin has been shown to be as effective as both amphotericin B deoxycholate and fluconazole when used as therapy for oropharyngeal and esophageal candidiasis.
“Caspofungin has been shown to be as effective as both amphotericin B deoxycholate and fluconazole when used as therapy for oropharyngeal and esophageal candidiasis [57][58][59][60].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [59]
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References 34 · Cited by 308
- Authors
- Villanueva, A., Arathoon, E. G., Gotuzzo, E., Berman, R. S., DiNubile, M. J., & Sable, C. A.
- Affiliations
- Universidad de Antioquia (CO)
- Hospital General San Juan de Dios (GT)
- Universidad Peruana Cayetano Heredia (PE)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-11
- Volume
- 33
- Issue
- 9
- Pages
- 1529-1535
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2142281465
- Cited by
- 308
- References
- 34
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 1 · 2018: 3 · 2017: 8 · 2016: 1 · 2015: 7 · 2014: 6 · 2013: 8 · 2012: 9
- FWCI
- 23.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- caspofungin, amphotericin B, candidal esophagitis, esophageal candidiasis, echinocandins, antifungal therapy, treatment efficacy, drug safety and tolerability, Candida
- MeSH terms
- Caspofungin, Adult, Aged, Amphotericin B, Anti-Bacterial Agents, Antifungal Agents, Candidiasis, Consumer Product Safety, Double-Blind Method, Drug Tolerance, Esophagitis, Esophagoscopy, Female, Humans, Male, Middle Aged, Peptides, Peptides, Cyclic, Echinocandins, Lipopeptides
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