An update on safety and efficacy of echinocandins in antifungal therapy
Journal Title: International Journal of Allied Medical Sciences and Clinical Research - Year 2017, Vol 5, Issue 3
Abstract
The echinocandins are important and exciting agents because of their novel mechanism of action, low incidence of serious adverse effects, and low potential for drug–drug interactions. In vitro and in vivo, the echinocandins are rapidly fungicidal against most Candida species and fungistatic against Aspergillus species.It is also a treatment option for serious fungal infections. Pharmacokinetic–pharmacodynamic studies in animals have demonstrated superior efficacy, defined as maximal microbial kill, when compared to fluconazole. Anidulafungin exhibits a unique pharmacokinetic profile, and limited cases have shown a potential for activity in isolates with increased minimum inhibitory concentrations to caspofungin and micafungin. Caspofungin appears to have a slightly higher incidence of side effects and potential for drug–drug interactions. Micafungin appears to be very similar to caspofungin, with very few obvious differences between the two agents and also have similar safety and efficacy profile in patients with fungal infections. Adverse events are generally mild, including (for caspofungin) local phlebitis, fever, abnormal liver function tests, and mild haemolysis. Anidulafungin is economical and have dominant efficacy compared with micafungin and caspofungin in patients with candidemia and/or invasive candidiasis. All three echinocandins are generally well-tolerated. Echinocandins provide safe, uncomplicated and highly active therapy for invasive Candida infections with potentially superior efficacy versus fluconazole and better tolerability compared to formulations like amphotericin B, making them the agents of choice for moderate to severely ill patients with invasive candidiasis.
Authors and Affiliations
Maryam Mahmoodan
Keywords
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