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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

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Echinocandins for the nursery: an update.

Paolo Manzoni¹, Daniel K Benjamin, Caterina Franco

¹Neonatology and NICU, S. Anna Hospital, Azienda Ospedaliera Regina Margherita - S. Anna, C.so Spezia 60. 10126 Torino, Italy. paolomanzoni@hotmail.com

Current Drug Metabolism

|September 1, 2012

Summary

Neonatal invasive fungal infections are rising, prompting research into new treatments. Echinocandins like Caspofungin and Micafungin show promise as effective and well-tolerated alternatives to traditional antifungal drugs.

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Area of Science:

Neonatal Medicine
Mycology
Pharmacology

Background:

Neonatal invasive fungal infections (IFI) incidence is increasing.
Current treatments (fluconazole, amphotericin B) have limitations in efficacy and toxicity.
Newer antifungal agents are needed for neonatal care.

Purpose of the Study:

To evaluate the potential of echinocandins as effective and well-tolerated antifungal drugs for neonatal invasive fungal infections.
To review the current evidence on the use of echinocandins in neonatal populations.

Main Methods:

Review of existing literature and subgroup analyses from pediatric and adult trials.
Pharmacokinetic and dosing studies in premature and term infants.
Assessment of activity against biofilms and fluconazole-resistant Candida species.

Main Results:

Echinocandins (caspofungin, micafungin) demonstrate good activity against biofilms and fluconazole-resistant Candida strains.
Subgroup analyses suggest caspofungin and micafungin are effective and well-tolerated in neonates.
Kinetics and dosing for caspofungin and micafungin in neonates have been described, but further research is ongoing.

Conclusions:

Echinocandins represent a promising therapeutic alternative for neonatal invasive fungal infections.
Further well-designed neonatal studies are required to confirm long-term safety and address ecological concerns.