Table 4

Risk factors for echinocandin failure

Variable% successa% failurebUnivariate analysis P valueMultivariate analysis P valuefOdds ratio (95% CI)
GI surgery within 30 days40% (11/29)80% (8/10)0.031NS (0.58)
TPN within 30 days31% (9/29)50% (5/10)NS (0.44)
Immunosuppressionc31% (9/29)50% (5/10)NS (0.44)
Previous echinocandin exposure21% (6/29)70% (7/10)0.008NS (0.73)
Previous azole exposure52% (15/29)70% (7/10)NS (0.47)
Median APS (range)8 (2–14)9 (5–15)NS (0.27)
Echinocandin MICd
    Caspofungin, >0.5 μg/ml14% (4/29)60% (6/10)0.009NS (0.49)
    Anidulafungin, >0.06 μg/ml3% (1/29)50% (5/10)0.002NS (0.66)
    Micafungin, >0.03 μg/ml10% (3/29)40% (4/10)0.06NS (0.39)
Presence of FKS mutation3% (1/29)60% (6/10)0.00040.00241.7 (3.96–445.7)
Initiation of antifungal within 48 he36% (9/25)33% (2/6)NS (1.00)
Initiation of antifungal within 72 he44% (11/25)50% (3/6)NS (1.00)
Initiation of antifungal within 120 he92% (23/25)67% (4/6)NS (0.16)
Initiation of echinocandin within 48 he17% (5/29)17% (1/6)NS (1.00)
Initiation of echinocandin within 72 he31% (9/29)33% (2/6)NS (1.00)
Initiation of echinocandin within 120 he79% (23/29)67% (4/6)NS (0.60)
  • a Results are no. of successful treatments/no. treated (n = 29) (does not apply for median APS).

  • b Results are no. of treatment failures/no. treated (n = 10) (does not apply for median APS).

  • c Immunosuppression was defined as a history of bone marrow or solid organ transplantation, or receipt of immunosuppressive therapy.

  • d Caspofungin, anidulafungin, and micafungin MICs were each considered individually in multivariate analyses.

  • e Patients with azole or echinocandin breakthrough IC were excluded from this analysis (n = 4 each).

  • f NS, not significant.