Antimicrobials
Caspofungin

Caspofungin

Low
N/A
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General Information

Primary Indication(s)

  • Empiric antifungal for severely ill patients with invasive Candida infection or patients at risk of fluconazole resistance (e.g. receiving fluconazole prophylaxis)
  • Empiric yeast therapy for febrile neutropenia
  • Fungal endocarditis

Alternative

  • An option for invasive Aspergillosis infections, but amphotericin or voriconazole is usually preferred
  • Antifungal prophylaxis if contraindication to other options
  • The echinocandins have poor urine penetration and should generally not be used for urinary infections.
  • Should not be used for CNS infections

Periodic liver function tests, renal function tests, CBC with differential

  • Increased liver enzymes
  • GI upset, diarrhea
  • Pruritis, fever (most common in pediatrics)
  • Potent enzyme inducers (e.g. rifampin): may decrease caspofungin exposure (see Dosing)
  • Cyclosporine: may increase caspofungin exposure and increased ALT/AST
  • Tacrolimus: caspofungin may decrease tacrolimus levels

Antimicrobial class: Echinocandin

CSF penetration: Poor

Urine penetration: Poor