Caspofungin plus AmB for Mucormycosis

In a small retrospective study, outcomes were significantly better with caspofungin plus any of three amphotericin B formulations than with amphotericin B alone.

Rhino-orbital-cerebral mucormycosis (ROCM) has a mortality rate of ≥50%. Amphotericin B (AmB) and its lipid formulations are the only antifungals approved for this condition. Based on in vitro inhibitory data, echinocandins such as caspofungin have been thought to have no activity against the causative fungi. But one such fungus, Rhizopus oryzae, contains the target enzyme 1,3-β-glucan synthase, and caspofungin, particularly when combined with AmB lipid complex (ABLC), has shown activity in a murine model of disseminated mucormycosis.

In 2004, based on these results, researchers began to use caspofungin in combination with various formulations of AmB for patients with ROCM. Now, these researchers have retrospectively reviewed cases of ROCM o…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)