Expansion of a recent class of broad-spectrum antifungal agents: the echinocandins

Abstract

Espansione di una recente classe di agenti antimicotici ad ampio spettro: le echinocandine SUMMARY The echinocandins show comparable efficacy in the treatment of candidemia and invasive candidiasis. Caspofungin and micafungin appear to be similarly efficacious in salvage therapy in aspergillosis; anidulafungin has excellent in vitro activity against Aspergillus species but as yet there are no sufficient clinical data for anidulafungin in this disease state. Each drug has minor advantages and disadvantages compared to the others of the same classe; however, there are large differences in the approved indications for the different drugs. The formulary selection process should consider the direct and indirect costs of the single agents; the characteristics of the patient population at risk for invasive mycosis, such as frequent use of interacting drugs and the burden of monitoring plasma drug levels of drugs; and the implications of using products for indications which have not been still approved (off-label indications).

Candida guilliermondii Peritonitis During Peritoneal Dialysis. Case Report and Literature Review

“…Overall, the isolates exhibit decreased in vitro susceptibility to fluconazole and echinocandins, whose activity may result dose-dependent [4], although poor biofilm formation and the low virulence have been associated with a favorable outcome [3]. The rate of true fluconazole resistance remains unknown [3] and the MICs of micafungin and anidulafungin have been detected 16and 60-fold higher, respectively, than the MICs against C. albicans [3].…”