title: Treatment of invasive candidiasis with echinocandins.
abstract: Blood stream infections by Candida spp. represent the majority of invasive fungal infections in intensive care patients. The high crude mortality of invasive candidiasis remained essentially unchanged during the last two decades despite new treatment options that became available. The echinocandins, the latest class of antifungals introduced since 2001, exhibit potent activity against clinically relevant fungi including most Candida spp. In several randomised multicentre phase III trials, anidulafungin, caspofungin and micafungin showed convincing efficacy when compared with standard treatment regimens. In all trials, echinocandins were at least non-inferior to standard treatments. Anidulafungin was shown to be superior to fluconazole. Echinocandins have a favourable tolerability profile and exhibit a minimal potential for drug interactions since their pharmacokinetics is independent of renal and--largely--hepatic function. As a result of these properties, echinocandins are appropriate drugs of choice for invasive candidiasis in intensive care where many patients experience organ failure and receive multiple drugs with complex interactions.
authors.affiliation: Neurologisches Rehabilitationszentrum Greifswald, Greifswald, Germany. a.gloeckner@nrz-greifswald.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Glöckner
authors.forename: Angela
authors.initials: A
authors.lastname: Steinbach
authors.forename: Jörg Janne
authors.initials: JJ
authors.lastname: Vehreschild
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy*; D003422:Critical Care / Q000379:methods; D054714:Echinocandins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins