Caspofungin in Combination with Itraconazole for the Treatment of Invasive Aspergillosis in Humans

Abstract

SIR—Caspofungin (Cancidas; Merck) belongs to a new class of antifungal agents, the echinocandins. It has in vitro fungicidal activity against numerous fungal pathogens, including Aspergillus species. Although no published studies have evaluated the use of caspofungin for treatment of invasive aspergillosis (IA) in humans, limited data have been reported that clinical improvement or complete response occurred in 41% of caspofungin-treated patients with IA who were intolerant of or had infections refractory to standard antifungal therapies [1]. No clinical data exist on the use of caspofungin in combination with other antifungal agents, which is an intriguing possibility, given caspofungin's unique mechanism of action. We report our experience with the use of caspofungin in combination with itraconazole in 2 immunocompromised patients with IA.