{blacktriangledown}Caspofungin and {blacktriangledown}voriconazole for fungal infections

doi:10.1136/dtb.2004.4215

Drug and Therapeutics Bulletin 2004;42:5-8; doi:10.1136/dtb.2004.4215

${blacktriangledown}$ Caspofungin and ${blacktriangledown}$ voriconazole for fungal infections

Relevant BNF section: 5.2

Systemic fungal infections are difficult to treat and oftenfatal. Established treatment options include conventional amphotericinB or one of its lipid-based or liposomal formulations, or atriazole antifungal such as fluconazole or itraconazole. ${blacktriangledown}$ Caspofungin(Cancidas - Merck Sharp & Dohme) and ${blacktriangledown}$ voriconazole (Vfend- Pfizer) are two new antifungals for severe infections causedby Candida spp. (invasive candidiasis) and Aspergillus spp.(invasive aspergillosis). Caspofungin is the first licensedechinocandin antifungal, while voriconazole is a triazole. Promotionalclaims for caspofungin include that it "provides an effective,yet less toxic, alternative to amphotericin B" while voriconazoleis claimed to offer "significantly improved survival in invasiveaspergillosis compared with amphotericin B". Here we considerthe place of caspofungin and voriconazole in managing patientswith severe fungal infections.