ISSN: 1859 - 2872
Analysis of treatment outcomes of caspofungin in invasive fungal infections at the 108 Military Central Hospital
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Abstract
Objective: To analyze consumption trends, epidemiological characteristics, antifungal susceptibility, and the effectiveness of caspofungin in the treatment of invasive fungal infections at the 108 Military Central Hospital. Subject and method: A retrospective descriptive study. Study subjects included data on caspofungin consumption from January 1, 2020 to June 30, 2025 extracted from the VIMES software, and patients who met the inclusion and exclusion criteria and were treated with caspofungin from January 1, 2024 to June 30, 2025. Result: Caspofungin consumption showed a significant increasing trend (Sen’s slope = 0.026 DDD/month; S=1100, p<0.001). Among 107 patients analyzed (mean age 66 years; 80.7% male; 57.0% admitted to ICU), the predominant isolates were C. tropicalis (45.7%), C. albicans (28.6%), and C. parapsilosis (11.4%). Susceptibility testing revealed 100% sensitivity of C. tropicalis and C. albicans to caspofungin, while 25% of C. parapsilosis isolates were resistant. At day 14, fungal clearance was achieved in 51.9% of evaluable patients. Overall, 68.2% achieved a favorable clinical response, with 57.9% cured or improved. The 30-day mortality rate was 38.3%. ICU admission was the strongest predictor of mortality (78.1% in the death group vs. 46.0% in survivors; p=0.001). Adverse events were rare, with only 2 cases of elevated liver enzymes (1.8%). Conclusion: The study demonstrated a significant increase in caspofungin consumption at the 108 Military Central Hospital during 2020–2025, highlighting its growing role in managing invasive fungal infections. C. tropicalis and C. albicans were the predominant pathogens, showing high susceptibility to caspofungin. Treatment outcomes and safety profiles were favorable; however, mortality remained high, especially among ICU patients.
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