P2367 Anidulafungin versus caspofungin for the treatment of proven invasive candidiasis; a retrospective comparative study

Reem Almaghrabi1, Abeer Al-jomaiah*2, Noha Mukhtar2, Wafa Alfahad3, Nisreen Al Sherbini4, Abeer Albaadani4, Ali Omrani2

1king faisal specialist hospital and research centre, medicine, riyadh, Saudi Arabia, 1king faisal specialist hospital and research centre, medicine, riyadh, Saudi Arabia, 3Prince Sultan Military Hospital , Pharamacy, Riyadh, Saudi Arabia, 4Prince Sultan Military Hospital , Medicine, Riyadh, Saudi Arabia

Background:

Invasive candidiasis (IC) is associated with considerable morbidity and mortality. The comparative efficacy of caspofungin compared with anidulafungin in the treatment of IC has not been reported. The aim of this study was to compare the clinical and microbiological outcomes of caspofungin and anidulafungin in the treatment of IC in Saudi Arabia.

Methods:

Retrospective, multicentre, cohort study of patients aged ≥18 years with microbiologically proved IC who received systemic caspofungin or anidulafungin for ≥ 5 days. Patients who received systemic amphotericin B or micafungin within the preceding 14 days were excluded. The primary endpoint was mortality at the end of IV antifungal therapy. Analyses were performed using IBM SPSS for Windows.

Results:

A total of 123 patients were included, 111 patients in the caspofungin group and 21 in the anidulafungin group. Significantly more patients with diabetes mellitus received anidulafungin while more patient on immunosuppressive therapy were in the caspofungin arm. There were no other significant differences in baseline characteristics between the two groups (Table 1). The median duration of therapy was 18 days for caspofungin and 19 days for anidulafungin group (p 0.23). Mortality at the end of antifungal therapy was observed in 41 (36.9%) in the caspofungin group compared with 11 (55%) in the anidulafungin group (P 0.23). In multivariate regression analysis, two variables were independently associated with the primary endpoint: transplant recipient status (odds ratio 3.07, 95% confidence interval 1.02 - 9.25) and candida species (OR 0.83, 95% CI 0.71 - 0.99).

Conclusions:

Morality at the end of antifungal therapy was not statistically different in patients with IC who received caspofungin or anidulafungin. Adequately powered randomized trials are required to confirm these findings.