Echinocandins in antifungal pharmacotherapy

Patil, Akash; Majumdar, Soumyajit

doi:10.1111/jphp.12780

Cited by 145Antifungal resistance and susceptibilityFungal Infections and StudiesFungal Plant Pathogen Control

Echinocandins in antifungal pharmacotherapy

Patil, Akash, Majumdar, Soumyajit·2017·Journal of Pharmacy and Pharmacology

DOI 10.1111/jphp.12780

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Abstract

Objectives: Echinocandins are the newest addition of the last decade to the antifungal armamentarium, which, owing to their unique mechanism of action, selectively target the fungal cells without affecting mammalian cells. Since the time of their introduction, they have come to occupy an important niche in the antifungal pharmacotherapy, due to their efficacy, safety, tolerability and favourable pharmacokinetic profiles. This review deals with the varying facets of echinocandins such as their chemistry, in-vitro and in-vivo evaluations, clinical utility and indications, pharmacokinetic and pharmacodynamic profiles, and pharmacoeconomic considerations. Key findings: Clinical studies have demonstrated that the echinocandins – caspofungin, micafungin and anidulafungin – are equivalent, if not superior, to the mainstay antifungal therapies involving amphotericin B and fluconazole. Moreover, echinocandin regimen has been shown to be more cost-effective and economical. Hence, the echinocandins have found favour in the management of invasive systemic fungal infections. Conclusions: The subtle differences in echinocandins with respect to their pharmacology, clinical therapy and the mechanisms of resistance are emerging at a rapid pace from the current pool of research which could potentially aid in extending their utility in the fungal infections of the eye, heart and nervous system.

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Echinocandins were the first systemic antifungals that targeted the cell wall by disrupting glucan production.
“Echinocandins were the first systemic antifungals that targeted the cell wall by disrupting the production of glucans (Patil and Majumdar, 2017).”
From Fungal Cell Wall: Emerging Antifungals and Drug Resistance. (2019) · cites this paper as Patil and Majumdar, 2017
Antifungals targeting cell wall production are more selective and less toxic than azole derivatives and amphotericin B.
“Since human cells do not have a covering wall, antifungals that target the production of cell wall components are more selective and less toxic when compared to azole derivatives and amphotericin B (Patil and Majumdar, 2017).”
From Fungal Cell Wall: Emerging Antifungals and Drug Resistance. (2019) · cites this paper as Patil and Majumdar, 2017

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“This antifungal class inhibits the β-D-glucan synthase, which leads to a decrease of the β-D-glucans in the cell wall after noncompetitively binding to the Fksp subunit of the enzyme (Hector, 1993; Denning, 2003; Aguilar-Zapata et al., 2015; Perlin, 2015; Patil and Majumdar, 2017).”
Background
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Authors: Patil, A., & Majumdar, S.
Affiliations: University of Mississippi (US)
Corresponding author: Majumdar, Soumyajit
ORCID: Patil, Akash
Venue: Journal of Pharmacy and Pharmacology
Publisher: Oxford University Press (OUP)
Published: 2017-12-01
Volume: 69
Issue: 12
Pages: 1635-1660
ISSN: 0022-3573 (ISSN-L)
2042-7158
DOI: 10.1111/jphp.12780
OpenAlex: W2739195081
Cited by: 145
References: 231
Citations by year: 2026: 8 · 2025: 11 · 2024: 13 · 2023: 19 · 2022: 16 · 2021: 27 · 2020: 25 · 2019: 15 · 2018: 9 · 2017: 2
FWCI: 10.73
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Journal of Pharmacy and Pharmacology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
Keywords: echinocandins, caspofungin, micafungin, anidulafungin, antifungal agents, invasive fungal infections, pharmacokinetics, pharmacodynamics, cost-effectiveness, antifungal resistance, amphotericin B, fluconazole, fungal eye infection, central nervous system fungal infection
MeSH terms: Caspofungin, Micafungin, Anidulafungin, Animals, Antifungal Agents, Humans, Mycoses, Drug Resistance, Fungal, Echinocandins, Lipopeptides

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Echinocandins in antifungal pharmacotherapy

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