Cited by 154Antifungal resistance and susceptibilityFungal Infections and StudiesFungal Plant Pathogen Control

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Pharmacology and metabolism of anidulafungin, caspofungin and micafungin in the treatment of invasive candidosis - review of the literature

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Kofla, G, Ruhnke, M·2011·European Journal of Medical Research

DOI 10.1186/2047-783x-16-4-159PMC PMC3352072

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Abstract

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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Authors: Kofla, G., & Ruhnke, M.
Affiliations: Charité – Universitätsmedizin Berlin (DE)
Corresponding author: Ruhnke, M
ORCID: Kofla, G
Ruhnke, M
Venue: European Journal of Medical Research
Publisher: Springer Science and Business Media LLC
Published: 2011
Volume: 16
Issue: 4
Pages: 159
ISSN: 0949-2321 (ISSN-L)
2047-783X
DOI: 10.1186/2047-783x-16-4-159
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 › Infectious Diseases › Fungal Infections and Studies
Life Sciences › Agricultural and Biological Sciences › Plant Science › 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

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Pharmacology and metabolism of anidulafungin, caspofungin and micafungin in the treatment of invasive candidosis - review of the literature

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