We tested the activity of anidulafungin against 30 Candida albicans isolates. The planktonic MICs for 50 and 90% of the isolates tested (MIC 50 and MIC 90 ) were <0.03 and 0.125 g/ml, respectively (MIC range, <0.03 to 2 g/ml). The sessile MIC 50 and MIC 90 were <0.03 and <0.03 g/ml, respectively (MIC range, <0.03 to >16 g/ml).Candida albicans infections seen in modern clinical practice, such as device-and intravascular catheter-related infections (2, 5), are associated with the growth of organisms in a biofilm state. Device removal is often necessary for a cure (7) since antimicrobials have traditionally been considered to be poorly active against microorganisms in biofilms. If, however, antimicrobials are active against microbial biofilms, device removal may be unnecessary. It has been proposed that antifungal agents that target cell wall synthesis may be active against C. albicans biofilms (1).We recently determined the in vitro antifungal activities of caspofungin and voriconazole against 30 clinical C. albicans isolates in their planktonic and sessile states. Susceptibility testing of the isolates in their planktonic and sessile forms revealed a marked rise in the voriconazole MIC for 90% of the isolates tested (MIC 90 ), which was much less marked for caspofungin (8). We also demonstrated that caspofungin was active in vivo in an experimental intravascular catheter infection model (9). Recently, Choi et al. reported that micafungin was active against biofilms formed by C. albicans (3), and Katragkou et al. reported that anidulafungin was active against two C. albicans strains in the biofilm state (6). The purpose of this study was to determine the in vitro activity of anidulafungin against our collection of C. albicans (8) grown in planktonic and sessile states.Thirty C. albicans clinical isolates obtained from sterile-site infections from October 2003 through October 2004 were studied (8). One isolate per patient was studied. Ten isolates were from blood cultures, including eight from patients with central venous catheters. The other 20 isolates were from peritoneal fluid (n ϭ 6), abscess fluid (n ϭ 5), soft tissue (n ϭ 5), bone (n ϭ 2), and pleural fluid and urine (n ϭ 1 each). C. albicans GDH2346 was used as a positive control. Anidulafungin concentrations ranging from 16 to 0.03 g/ml were tested.Planktonic MICs were determined by Clinical and Laboratory Standards Institute broth microdilution methods (4). The lowest concentration associated with a significant reduction in turbidity compared with the control well at 48 h was reported as the MIC (4). Isolates for which the MICs were Ͼ0.125 g/ml were retested and read at 24 and 48 h, as others have reported MICs after 24 h (6).Sessile MICs were determined with biofilms formed in 96-well flat-bottom microtiter plates as previously described (8). Yeast cells were grown overnight in yeast nitrogen base medium, washed twice in sterile phosphate-buffered saline (PBS), and standardized to 1 ϫ 10 7 CFU/ml in RPMI medium. Each well was filled with 100 l C. albican...