Antifungal Susceptibility Survey of 2,000 Bloodstream
            <i>Candida</i>
            Isolates in the United States

Ostrosky-Zeichner, Luis; Rex, John H.; Pappas, Peter G.; Hamill, Richard J.; Larsen, Robert A.; Horowitz, Harold W.; Powderly, William G.; Hyslop, Newton E.; Kauffman, Carol A.; Cleary, John D.; Mangino, Julie E.; Lee, Jeannette

doi:10.1128/aac.47.10.3149-3154.2003

Cited by 476 publications

(390 citation statements)

References 41 publications

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“…In a similar population, caspofungin yielded an 81% success rate among patients evaluable for analysis (9). Larger studies will be needed to explore differences in response rates by species, since, as for other echinocandins, higher MICs are observed for C. parapsilosis than for other species (12).…”

Section: Discussionmentioning

confidence: 99%

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Krause¹,

Reinhardt

Vázquez

et al. 2004

Antimicrob Agents Chemother

164

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This study evaluated the safety and efficacy of anidulafungin, a novel echinocandin, in patients with invasive candidiasis, including candidemia. A total of 123 eligible patients were randomized to one of three intravenous regimens, 50, 75, or 100 mg once daily. Treatment continued for 2 weeks beyond resolution or improvement of signs and symptoms. The primary efficacy criterion was a successful global response rate (i.e., clinical and microbiological success) in the evaluable population at the follow-up (FU) visit, 2 weeks after end of therapy (EOT). One hundred twenty (120) patients received at least one dose of anidulafungin; 68 were evaluable. Review of adverse events and laboratory data indicated no dose response for safety parameters. Non-albicans Candida species accounted for approximately one-half of all isolates. Success rates at EOT were 84, 90, and 89% in the 50-, 75-, and 100-mg groups, respectively. At FU, the success rates were 72, 85, and 83%. Phase 3 studies of anidulafungin for the treatment of invasive candidiasis and candidemia are warranted.

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Section: Discussionmentioning

confidence: 99%

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Krause¹,

Reinhardt

Vázquez

et al. 2004

Antimicrob Agents Chemother

164

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“…32 Micafungin shows potent fungicidal activity against clinically isolated yeast species of Candida, including C. albicans, C. dubliniensis, C. tropicalis, C. glabrata and C. krusei, and against C. parapsilosis, C. lusitaniae and C. guilliermondii with slightly higher MIC 90 values. [33][34][35] No cross-resistance to fluconazole-resistant clinical isolates of Candida has been observed. 36 Characteristically, micafungin has potent in vitro inhibitory activity against Aspergillus species at lower concentrations than amphotericin B and itraconazole, but micafungin was not fungicidal against Aspergillus spp.…”

Section: Pre-clinical Study Of Fk463mentioning

confidence: 99%

Micafungin: a sulfated echinocandin

Hashimoto

2009

J Antibiot

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Micafungin is the second approved antifungal agent in the echinocandin series and is now used worldwide in chemotherapy for life-threatening fungal infections. It is water-soluble and is semi-synthesized from the acylated cyclic hexapeptide FR901379, a natural product from the fungus Coleophoma empetri F-11899, through enzymatic deacylation of FR901379, followed by chemical reacylation with the optimized N-acyl side chain. The water solubility of micafungin is ascribed to a sulfate moiety in the molecule. This feature differentiates micafungin from other echinocandin members. Micafungin is a potent inhibitor of 1,3-b-glucan synthase, an enzyme necessary for cell-wall synthesis of several fungal pathogens. The Journal of Antibiotics (2009) and Cryptococcus neoformans are a threat to human health. Incidences of these systemic fungal infections have increased significantly over the past few years. The major reasons for this dramatic increase are the extensive use of broad-spectrum antibiotics and the growing number of immunocompromised patients with acquired immunodeficiency syndrome (AIDS), cancer and transplants. 1,2 In the mid 1900s, few compounds, such as polyenes (for example, nystatin and amphotericin B) and flucytosine, were available for antifungal chemotherapy. Although the development of azole drugs started in the early 1970s, only a limited number of antifungal agents were available for treatment of life-threatening fungal infections. Moreover, the existing agents had disadvantages, such as the significant nephrotoxicity of amphotericin B 3 and the emergence of resistance to the azoles. 4 To overcome these defects, lipid formulations of polyenes were developed to reduce toxicity, and new triazoles (for example, voriconazole, ravuconazole and posaconazole) were developed to improve the antifungal spectra or susceptibility to azoleresistant isolates. 5 Despite a number of therapeutic advancements, there was a need to develop a new class of antifungal agents with novel mechanisms of action.

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“…This new class includes caspofungin, anidulafungin, both now available in Europe, and micafungin, which is not yet marketed. Echinocandins are fungicidal drugs that are active against both C. albicans Table 1 Minimum inhibitory concentration (50/90%) of antifungal agents against the most common Candida species Amphotericin B (lg/ml) [44] Flucytosine (lg/ml) [44] Fluconazole (lg/ml) [44] Voriconazole (lg/ml) [44] Caspofungin (lg/ml) [44] Anidulafungin (lg/ml) [44] and non-albicans species. Caspofungin has been shown to be as effective as, and better tolerated than, conventional amphotericin B in patients with invasive candidiasis [23].…”

Section: Treatment Of Documented Infectionmentioning

confidence: 99%

Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment

et al. 2008

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Background: Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). Objective and methods: To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and an European expert panel discussion. Results and conclusions: Empiric and directed treatment for invasive candidiasis are predicated on the hemodynamic status of the patient. Unstable patients may benefit from broad-spectrum antifungal agents, which can be narrowed once the patient has stabilized and the identity of the infecting species is established. In stable patients, a more classical approach using fluconazole may be satisfactory provided that the patient is not colonized Intensive Care Med

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Antifungal Susceptibility Survey of 2,000 Bloodstream Candida Isolates in the United States

Cited by 476 publications

References 41 publications

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Micafungin: a sulfated echinocandin

Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment

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