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.

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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 Jan 15;

Authors: Kim T, Hong HL, Lee YM, Sung H, Kim SH, Choi SH, Kim YS, Woo JH, Lee SO

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.

PMID: 23317167 [PubMed - as supplied by publisher]