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Anidulafungin in the treatment of patients with invasive candidiasis

Daniel H Kett1, G Fernando Cubillos

  • 1University of Miami Miller School of Medicine, Miami, FL 33101-6960, USA. d.kett@miami.edu

International Journal of Antimicrobial Agents
|December 17, 2008
PubMed

Insights

Echinocandins are recommended for invasive candidiasis treatment, especially in severe cases or those with azole resistance risk. Anidulafungin shows higher response rates and improved survival trends compared to fluconazole.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Mycology

Background:

  • Invasive candidiasis requires effective antifungal therapy.
  • Echinocandins are emerging as key agents for treating invasive fungal infections.
  • Azole resistance is a growing concern in Candida infections.

Purpose of the Study:

  • To review the role of echinocandins in invasive candidiasis treatment.
  • To compare the efficacy of anidulafungin with fluconazole.
  • To guide the selection of echinocandins based on patient factors and pathogen susceptibility.

Main Methods:

  • Review of clinical trial data and guidelines.
  • Comparative analysis of echinocandin efficacy and safety.
  • Discussion of treatment strategies including empirical and step-down therapy.

Main Results:

  • Anidulafungin demonstrated higher response rates than fluconazole in invasive candidiasis.
  • A trend towards improved survival was observed with anidulafungin compared to fluconazole.
  • The three available echinocandins (anidulafungin, caspofungin, micafungin) offer proven efficacy and favorable side-effect profiles.

Conclusions:

  • Echinocandins are recommended for initial therapy in severely ill patients or those at risk for azole resistance.
  • Selection of an echinocandin should be individualized based on patient status, suspected pathogen, and institutional susceptibility patterns.
  • Step-down therapy with azoles (fluconazole or voriconazole) is a viable option after pathogen identification and susceptibility testing.

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