EUCAST technical note on anidulafungin.

Area of Science:

• Medical Microbiology
• Clinical Mycology
• Pharmacology

Background:

• Antifungal susceptibility testing is crucial for guiding therapy against Candida infections.
• Anidulafungin is an echinocandin antifungal agent.
• Establishing standardized breakpoints ensures consistent interpretation of susceptibility data.

Purpose of the Study:

• To present the European Committee on Antimicrobial Susceptibility Testing-Subcommittee on Antifungal Susceptibility Testing (EUCAST-AFST) determined breakpoints for anidulafungin.
• To provide guidance on interpreting anidulafungin susceptibility for common Candida species.

Main Methods:

• The breakpoints were determined based on pharmacokinetic data, epidemiological cut-off values, and clinical experience.
• Data from the EUCAST anidulafungin rationale document were utilized.
• Species-specific breakpoints were defined for Candida albicans, Candida glabrata, Candida tropicalis, and Candida krusei.

Main Results:

• For Candida albicans, susceptibility breakpoints (S) are ≤0.03 mg/L, and resistance (R) is >0.03 mg/L.
• For Candida glabrata, Candida tropicalis, and Candida krusei, S ≤0.06 mg/L and R >0.06 mg/L.
• Candida parapsilosis was not considered a suitable target for anidulafungin, and data for other species were insufficient.

Conclusions:

• EUCAST-AFST has established clinically relevant breakpoints for anidulafungin against key Candida species.
• These breakpoints will aid in the clinical management of candidiasis.
• Breakpoints will undergo regular review and updates as new data become available.