Subtherapeutic ocular penetration of caspofungin and associated treatment failure in Candida albicans endophthalmitis
Abstract
Candida endophthalmitis represents the most serious ocular complication of candidemia. The pharmacokinetics and pharmacodynamics of fluconazole, amphotericin B, and flucytosine are fairly well established in endophthalmitis therapy. There remains a paucity of clinical data regarding the utility of new antimycotic agents in the treatment of fungal chorioretinitis and endophthalmitis. We report a case of clinical failure of caspofungin in the management of Candida albicans endophthalmitis associated with poor vitreous penetration.
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Endophthalmitis is a not uncommon complication in patients with candidemia, with an incidence ranging from 3% to 28% in prospective studies, and carries significant morbidity.
“Endophthalmitis is a not uncommon complication in patients with candidemia, with an incidence ranging from 3% to 28% in prospective studies, and carries significant morbidity.”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [126]
For fluconazole-resistant isolates, liposomal amphotericin B is preferred over echinocandins, which achieve suboptimal vitreous concentrations.
“For fluconazole-resistant isolates, liposomal amphotericin B is preferred over echinocandins, which achieve suboptimal vitreous concentrations [109,110].”
From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [110]
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Pharmacotherapy of Micafungin: Clinical Review
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Inpatient ophthalmology consultations for candidemia: a literature review and opinion
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ANTIFUNGAL AGENTS IN TERMS OF ACQUIRED RESISTANCE IN CANDIDA SPECIES
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- Authors
- Gauthier, G. M., Nork, T. M., Prince, R., & Andes, D.
- Affiliations
- University of Wisconsin–Madison (US)
- University of Houston (US)
- ORCID
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-08-01
- Volume
- 41
- Issue
- 3
- Pages
- e27-e28
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2124127923
- Cited by
- 99
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 6 · 2014: 7 · 2013: 4 · 2012: 4
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Keywords
- caspofungin, Candida albicans, fungal endophthalmitis, ocular penetration, treatment failure, antifungal pharmacokinetics, candidemia
- MeSH terms
- Caspofungin, Adult, Amphotericin B, Antifungal Agents, Candidiasis, Drug Combinations, Humans, Male, Endophthalmitis, Peptides, Cyclic, Phosphatidylcholines, Phosphatidylglycerols, Treatment Failure, Echinocandins, Lipopeptides
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