The Echinocandins

  title={The Echinocandins},
  author={Diane M. Cappelletty and Kasi Eiselstein-McKitrick},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
The changing pattern in fungal infections has driven the need to expand the targets of antifungal activity. The echinocandins are the newest addition to the arsenal against fungal infections. Three echinocandins have been approved by the United States Food and Drug Administration: caspofungin, micafungin, and anidulafungin. These agents have a broad spectrum of activity and are similar to each other with respect to in vitro activity against Candida sp, with micafungin and anidulafungin having… 

Current perspectives on echinocandin class drugs.

The echinocandin drugs have a limited antifungal spectrum but are highly active against most Candida spp.

Treatment of invasive candidiasis with echinocandins

Echinocandins have a favourable tolerability profile and exhibit a minimal potential for drug interactions since their pharmacokinetics is independent of renal and hepatic function, and are appropriate drugs of choice for invasive candidiasis in intensive care where many patients experience organ failure and receive multiple drugs with complex interactions.

Antimycotic Drugs and their Mechanisms of Resistance to Candida Species.

The major molecular mechanisms for the development of antifungal drug resistance are summarized and the success rates of treatment have been reduced as well as major changes have been observed in the frequency of fungal infections.

Micafungin versus caspofungin in the treatment of Candida glabrata infection: a case report

In vitro, micafungin is considered more effective against C. glabrata than caspofungin because its minimum inhibitory concentration againstC.

Echinocandin pharmacodynamics: review and clinical implications.

The potential impact of dose escalations on improving the clinical efficacy of echinocandins based on in vitro and animal models are uncertain and are still being evaluated.

Paradoxical growth effects of the echinocandins caspofungin and micafungin, but not of anidulafungin, on clinical isolates of Candida albicans and C. dubliniensis

Anidulafungin has effects that are different from the ones produced by micaf ungin and caspofungin, and whether this different response to high concentrations of echinocandins is based on genetic or phenotypic differences between C. albicans and C. dubliniensis has to be determined in future experiments.

FKS Mutations and Elevated Echinocandin MIC Values among Candida glabrata Isolates from U.S. Population-Based Surveillance

With a rising number of echinocandin therapy failures reported, it is important to continue to monitor rates of elevated echinOCandin MIC values and the associated mutations.

Echinocandins: The Newest Class of Antifungals

Echinocandins, the newest addition to the arsenal of antifungals, offer potential advantages over other classes of agents, and clinicians should assess their distinguishing characteristics, including route of metabolism, drug interaction profile, and approved indications for use, when determining which agent to include on a formulary.

Differential Aspergillus lentulus Echinocandin Susceptibilities Are Fksp Independent

The data suggest that differential echinocandin susceptibilities in A. lentulus are independent of the fksp target, Fksp, and they emphasize the potential that the drugs' capacity to inhibit the target enzyme is unequal at the cellular level.

Micafungin: a review of its use in the prophylaxis and treatment of invasive Candida infections in pediatric patients.

Results of pediatric substudies indicate that intravenous micafungin is effective in a majority of patients for the treatment of candidemia and other types of invasive candidiasis, and provides effective prophylaxis against invasive fungal infections in pediatric patients undergoing HSCT.



Progressive loss of echinocandin activity following prolonged use for treatment of Candida albicans oesophagitis.

A progressive loss of activity of all three echinocandin drugs against clonally related C. albicans isolates following long-term clinical exposure to this new class of antifungal agents is documents for the first time.

Activities of Micafungin against 315 Invasive Clinical Isolates of Fluconazole-Resistant Candida spp

The new echinocandin micafungin has excellent in vitro activity against 315 invasive clinical isolates of fluconazole-resistant Candida species obtained from geographically diverse medical centers between 2001 and 2004 and may prove useful in the treatment of infections due to azole- resistant Candida.

In Vitro Activities of Anidulafungin against More than 2,500 Clinical Isolates of Candida spp., Including 315 Isolates Resistant to Fluconazole

The results provide further evidence for the spectrum and potency of anidulafungin activity against a large and geographically diverse collection of clinically important isolates of Candida spp.

In Vitro Activities of Caspofungin Compared with Those of Fluconazole and Itraconazole against 3,959 Clinical Isolates of Candida spp., Including 157 Fluconazole-Resistant Isolates

ABSTRACT Caspofungin is an echinocandin antifungal agent with broad-spectrum activity against Candida and Aspergillus spp. The in vitro activities of caspofungin against 3,959 isolates of Candida

Comparison of caspofungin and amphotericin B for invasive candidiasis.

Caspofungin is at least as effective as amphotericin B for the treatment of invasive candidiasis and, more specifically, candidemia.

In vitro interaction of micafungin with conventional and new antifungals against clinical isolates of Trichosporon, Sporobolomyces and Rhodotorula.

Some of the combinations tested, especially micafungin/amphotericin B, have potential for the treatment of basidiomycetous yeast infections.

Postantifungal Effects of Echinocandin, Azole, and Polyene Antifungal Agents against Candida albicans andCryptococcus neoformans

ABSTRACT The postantifungal effect (PAFE) of fluconazole, MK-0991, LY303366, and amphotericin B was determined against isolates of Candida albicans and Cryptococcus neoformans. Concentrations ranging

Susceptibility of Pseudallescheria boydii and Scedosporium apiospermum to new antifungal agents.

It is suggested that voriconazole is a promising new drug in these infections, and that the same antifungal strategy can be employed in the infections by P. boydii and S. apiospermum.

In Vitro Activity of Micafungin (FK-463) against Candida spp.: Microdilution, Time-Kill, and Postantifungal-Effect Studies

Micafungin is very potent agent against a variety of Candida spp.