WEDNESDAY, Dec. 18, 2002 (HealthDayNews) -- For most of us, fungal infections are an annoying but mostly harmless fact of life. Athlete's foot and yeast infections are hardly killers.
But fungus is a different story for sick people whose bodies are too weak to put up a strong defense against attacks launched against their blood vessels and internal organs.
Now, there's a new medication on the market to help the most vulnerable patients, and research funded by a drug company suggests that it works as well as an existing product without the troublesome side effects.
The new drug, known as caspofungin, will help combat the "hidden plague" of serious fungal infections in hospitals, said study co-author Dr. John Perfect, an associate professor of medicine at Duke University.
"Fungal infections complicate modern medicine and without control of them, many lifesaving therapies for other serious diseases will be compromised," he said.
Various types of fungus live naturally in our bodies and occasionally cause infections in places like the toenails, the mouth (in a disease called thrush), and the vagina. In patients with weakened immune systems, however, fungi can travel into the body and cause a disease known as candidiasis.
The disease can kill 30 to 40 percent of those who are infected, Perfect said. The most vulnerable patients are HIV-positive people, organ transplant recipients, chemotherapy patients, and those who have catheters inserted.
According to Perfect, doctors have mainly used two drugs to treat candidiasis. Amphotericin B, which has been available for about 45 years, works well but has serious side effects. Nurses call it a "beast of a drug," Perfect said.
The second drug, fluconazole, is safer but doesn't work against all strains of the disease, he said.
Perfect and colleagues tested new and old drugs in more than 200 patients from around the world. The study was funded by Merck, manufacturer of caspofungin.
The study findings appear in the Dec. 19 issue of the New England Journal of Medicine.
The study found that caspofungin treated candidiasis as well as amphotericin B but without as many side effects, Perfect said.
"The disadvantage is that this agent must be given through the veins and cannot be taken by mouth," he said. "This is not a problem in the hospital but becomes more difficult to give outside the hospital setting."
Another physician, Dr. Judith Feinberg of the University of Cincinnati College of Medicine, predicted that caspofungin will not become popular immediately.
"It's new and will therefore be expensive," said Feinberg, a professor of medicine who specializes in treating AIDS patients. "It will be reserved for the sickest kinds of patients who are in the hospital and for one reason or another have not responded to fluconazole."
The federal government has not yet approved caspofungin for use in candidiasis patients, Perfect said. That means Merck cannot advertise the drug for use in those patients. However, doctors can still legally use the drug for "off-label" purposes such as treating candidiasis.
What To Do
Get a primer on candidiasis from Medline. And learn more about fungus from (who else?) Doctor Fungus.
