Antifungal activity of rezafungin in invasive candidiasis: From bench to bed

Invasive mycoses present significant medical challenges, with new populations at risk and the emergence of antifungal resistance. Therapeutic options for antifungal treatment are limited and further complicated by drug-drug interactions, toxicity, and constraints in administration routes. Despite the urgent need for more antifungal drugs, few new antifungal drugs have been introduced over the past decades. Nevertheless, there is hope on the horizon, with new antifungal drugs approved or in late-stage clinical trials. In this review, we critically examine the antifungal activity of rezafungin, a new-generation echinocandin with distinctive PK/PD properties, including high stability that enables once-weekly dosing, as well as elevated peak concentrations (C_max) and area under the curve (AUC) values, and its therapeutic utility in the treatment of invasive candidiasis. We focus on its mechanism of action, as well as on its broad spectrum of activity against emergent species of Candida and other pathogenic fungi. Additionally, we highlight its utility in the treatment of candidemia and other forms of invasive candidiasis in various medical settings, and the potential future roles of rezafungin and the unmet needs in this field.