Pharmacology and metabolism of anidulafungin, caspofungin and micafungin in the treatment of invasive candidosis - review of the literature
Open accessAbstract
Echinocandins represent the newest class of antifungal agents. Currently, three echinocandins, anidulafungin, caspofungin and micafungin are licensed for clinical use in various indications. They act as inhibitors of β-(1,3)-glucan synthesis in the fungal cell wall and have a favorable pharmacological profile. They have a broad spectrum of activity against all Candida species. Higher MIC's have been observed against C. parapsilosis and C. guilliermondii. Data from clinical trials for invasive Candida infections / candidaemia suggest that the clinical outcome of patients treated with either drug may be very similar. A comparison has been done between caspofungin and micafungin but for anidulafungin a comparative trial with another echinocandin is still lacking. All three drugs are highly effective if not superior to treatment with either fluconazole or Amphotericin B, particularly in well-defined clinical settings such as invasive Candida infections, Candida oesophagitis and candidaemia. Differences between the three echinocandins with regard to the route of metabolism, requirement for a loading dose, dose adjustment in patients with moderate to severe hepatic disease and different dosing schedules for different types of Candida infections have to be considered. Relevant drug-drug interactions of Caspofungin and Micafungin are minimal. Anidulafungin has no significant drug interactions at all. However, echinocandins are available only for intravenous use. All three agents have an excellent safety profile.
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Rezafungin has a half-life of over 130 h in humans, compared to 24, 9-11, and 10-17 h for anidulafungin, caspofungin, and micafungin, respectively.
“It is highly soluble in aqueous systems and has a half-life of over 130 h in humans, compared to 24, 9–11, 10–17 h half-lives of anidulafungin, caspofungin, and micafungin, respectively (Kofla and Ruhnke, 2011; Sandison et al., 2017).”
From Fungal Cell Wall: Emerging Antifungals and Drug Resistance. (2019) · cites this paper as Kofla and Ruhnke, 2011
Table 1 in the Pharmacokinetics section gives the cited elimination half-lives for anidulafungin (24 h), caspofungin (9–11 h), and micafungin (10–17 h). The supplied passages do not address rezafungin, so this source does not support the attributed half-life of over 130 h or its aqueous solubility. (LLM, conf=0.90)
Experimental — accuracy not yet measuredSemisynthetic natural products derived from echinocandins showed improved properties over the parental compounds.
“Finally, the last group includes compounds which are derived from semisynthetic natural products, such as compounds derived from echinocandins: micafungin sodium, anidulafungin, caspofungin acetate, and pneumocandin. These agents showed improved properties over the parental compounds [50, 141].”
From <i>Candida</i>Infections, Causes, Targets, and Resistance Mechanisms: Traditional and Alternative Antifungal Agents (2013) · cites this paper as [141]
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- Authors
- Kofla, G., & Ruhnke, M.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Ruhnke, M
- Venue
- European Journal of Medical Research
- Published
- 2011
- Volume
- 16
- Issue
- 4
- Pages
- 159
- ISSN
- 0949-2321 (ISSN-L)
- 2047-783X
- PMC
- PMC3352072
- OpenAlex
- W2072639782
- Cited by
- 153
- References
- 78
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 8 · 2023: 14 · 2022: 14 · 2021: 12 · 2020: 16 · 2019: 14 · 2018: 10 · 2017: 13 · 2016: 10 · 2015: 9 · 2014: 8 · 2013: 6 · 2012: 2
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- European journal of medical research (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- anidulafungin, caspofungin, micafungin, echinocandins, invasive candidiasis, candidemia, Candida parapsilosis, Candida guilliermondii, pharmacokinetics, drug-drug interactions, liver dysfunction, loading dose, dosing regimen, fluconazole, amphotericin B
- MeSH terms
- Caspofungin, Micafungin, Anidulafungin, Antifungal Agents, Drug Interactions, Humans, Molecular Structure, Biofilms, Drug Resistance, Fungal, Echinocandins, Lipopeptides, Candidiasis, Invasive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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