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Title: Efficacy and safety of anidulafungin in elderly, critically ill patients with invasive Candida infections: a post hoc analysis
Authors: Dimopoulos, George ×
Paiva, José-Artur
Meersseman, Wouter
Pachl, Jan
Grigoras, Ioana
Sganga, Gabriele
Montravers, Philippe
Auzinger, Georg
Sá, Marcio Borges
Miller, Paul J
Marček, Tomas
Kantecki, Michal
Ruhnke, Markus #
Issue Date: Dec-2012
Publisher: Elsevier Science Publishers
Series Title: International journal of antimicrobial agents vol:40 issue:6 pages:521-526
Article number: S0924-8579(12)00323-8
Abstract: Post hoc analysis of a non-comparative, prospective, multicentre, phase IIIb study was performed to compare efficacy and safety of anidulafungin in elderly (≥65 years) versus non-elderly (<65 years) Intensive Care Unit (ICU) patients with candidaemia/invasive candidiasis (C/IC). Adult ICU patients with confirmed C/IC meeting ≥1 of the following criteria were enrolled: post-abdominal surgery; solid tumour; renal/hepatic insufficiency; solid organ transplantation; neutropenia; age ≥65 years. Patients received anidulafungin (200mg on Day 1, 100mg/day thereafter) for ≥10 days followed by optional azole step-down therapy for a total treatment duration of 14-56 days. The primary efficacy endpoint was global (clinical and microbiological) response at the end of all therapy (EOT). Primary efficacy analysis was performed in the modified intent-to-treat (mITT) population (n=170), excluding unknown and missing responses. In total, 80 patients (47.1%) were aged ≥65 years and 90 (52.9%) were aged <65 years; the mean age difference between the two groups was 21.9 years. Global success at EOT in mITT patients was similar in elderly (68.1%) and non-elderly (70.7%) patients (P=0.719). However, global success rates were significantly lower in elderly versus non-elderly patients at 2 and 6 weeks after EOT (P=0.045 and P=0.016, respectively). Ninety-day survival was significantly lower (P=0.006) for elderly (42.8%) versus non-elderly patients (63.3%). The incidence and profile of adverse events were similar in elderly and non-elderly patients. Anidulafungin was effective and safe for treatment of C/IC in elderly ICU patients, despite higher baseline severity of illness scores.
URI: 
ISSN: 0924-8579
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
× corresponding author
# (joint) last author

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