Abstract
Ever since the discovery that penicillin inhibits bacterial cell wall synthesis, developing equivalent agents to target the fungal cell wall has been a focus of antifungal drug development. Because the cell wall is essential to the vitality of fungal organisms and because its components are absent in the mammalian host, the fungal cell wall represents an ideal target for antifungal compounds. With considerable variation among different species, the gross macromolecular components of the cell wall of most fungi include chitin, alpha- or beta-linked glucans, and a variety of mannoproteins. The dynamics of the fungal cell wall are closely coordinated with cell growth and cell division, and the predominant function of the cell wall is to control the internal turgor of the cell. Disruption of the cell wall structure leads to osmotic instability and may ultimately result in the lysis of the fungal cell. The echinocandins are antifungal agents whose actions are directed against the major constituents of the fungal cell wall.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hector RF. Compounds active against cell walls of medically important fungi. Clin Microbiol Rev. 1993;6:1–21.
Debono M, Gordee RS. Antibiotics that inhibit fungal cell wall development. Ann Rev Microbiol. 1994;48:471–97.
Groll AH, Piscitelli SC, Walsh TJ. Clinical pharmacology of systemic antifungal agents: a comprehensive review of agents in clinical use, current investigational compounds, and putative targets for antifungal drug development. Adv Pharmacol. 1998;44:343–500.
Damle BD, Dowell JA, Walsky RL, Weber GL, Stogniew M, Inskeep PB. In vitro and in vivo studies to characterize the clearance mechanism and potential cytochrome P450 interactions of anidulafungin. Antimicrob Agents Chemother. 2009;53:1149–56.
Damle B, Stogniew M, Dowell J. Pharmacokinetics and tissue distribution of anidulafungin in rats. Antimicrob Agents Chemother. 2008;52:2673–6.
Hajdu R, Thompson R, Sundelof JG, et al. Preliminary animal pharmacokinetics of the parenteral antifungal agent MK-0991 (L-743, 872). Antimicrob Agents Chemother. 1997;41:2339–44.
Stone JA, Xu X, Winchell GA, et al. Disposition of caspofungin: role of distribution in determining pharmacokinetics in plasma. Antimicrob Agents Chemother. 2004;48:815–23.
Walsh TJ, Adamson PC, Seibel NL, et al. Pharmacokinetics, safety, and tolerability of caspofungin in children and adolescents. Antimicrob Agents Chemother. 2005;49:4536–45.
Niwa T, Yokota Y, Tokunaga A, et al. Tissue distribution after intravenous dosing of micafungin, an antifungal drug, to rats. Biol Pharm Bull. 2004;27:1154–6.
Hebert MF, Townsend RW, Austin S, et al. Concomitant cyclosporine and micafungin pharmacokinetics in healthy volunteers. J Clin Pharmacol. 2005;45:954–60.
Kurtz MB, Douglas CM. Lipopeptide inhibitors of fungal glucan synthase. J Med Vet Mycol. 1997;35:79–86.
Leventakos K, Ben Ami R, Lewis RE, Kontoyiannis DP. Immunomodulating effects of antifungal therapy. Curr Fungal Infect Rep. 2009;3:43–50.
Bartizal K, Gill CJ, Abruzzo GK, et al. In vitro preclinical evaluation studies with the echinocandin antifungal MK-0991 (L-743, 872). Antimicrob Agents Chemother. 1997;41:2326–32.
Watabe E, Nakai T, Matsumoto S, Ikeda F, Hatano K. Killing activity of micafungin against Aspergillus fumigatus hyphae assessed by specific fluorescent staining for cell viability. Antimicrob Agents Chemother. 2003;47:1995–8.
Kurtz MB, Heath IB, Marrinan J, Dreikorn S, Onishi J, Douglas CM. Morphological effects of lipopeptides against Aspergillus fumigatus correlate with activities against (1, 3)-beta-D-glucan synthase. Antimicrob Agents Chemother. 1994;38:1480–9.
Oakley KL, Moore CB, Denning DW. In vitro activity of the echinocandin antifungal agent LY303, 366 in comparison with itraconazole and amphotericin B against Aspergillus spp. Antimicrob Agents Chemother. 1998;42:2726–30.
Bowman JC, Hicks PS, Kurtz MB, et al. The antifungal echinocandin caspofungin acetate kills growing cells of Aspergillus fumigatus in vitro. Antimicrob Agents Chemother. 2002;46:3001–12.
Pfaller MA, Boyken L, Hollis RJ, et al. In vitro susceptibility of invasive isolates of Candida spp. to anidulafungin, caspofungin, and micafungin: six years of global surveillance. J Clin Microbiol. 2008;46:150–6.
Espinel-Ingroff A. Comparison of in vitro activities of the new triazole SCH56592 and the echinocandins MK-0991 (L-743, 872) and LY303366 against opportunistic filamentous and dimorphic fungi and yeasts. J Clin Microbiol. 1998;36:2950–6.
Tawara S, Ikeda F, Maki K, et al. In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi. Antimicrob Agents Chemother. 2000;44:57–62.
Groll AH, Walsh J. Caspofungin: Pharmacology, safety, and therapeutic potential in superficial and invasive fungal infections. Exp Opin Invest Drugs. 2001;10:1545–58.
Groll AH, Stergiopoulou T, Roilides E, Walsh TJ. Micafungin: pharmacology, experimental therapeutics and clinical applications. Expert Opin Invest Drugs. 2005;14:489–509.
Vazquez JA, Sobel JD. Anidulafungin: a novel echinocandin. Clin Infect Dis. 2006;43:215–22.
Wiederhold NP, Lewis JS. The echinocandin micafungin: a review of the pharmacology, spectrum of activity, clinical efficacy and safety. Expert Opin Pharmacother. 2007;8:1155–66.
Hope WW, Shoham S, Walsh TJ. The pharmacology and clinical use of caspofungin. Expert Opin Drug Metab Toxicol. 2007;3:263–74.
Estes KE, Penzak SR, Calis KA, Walsh TJ. Pharmacology and antifungal properties of anidulafungin, a new echinocandin. Pharmacotherapy. 2009;29:17–30.
Pfaller MA, Boyken L, Hollis RJ, et al. In vitro susceptibility of clinical isolates of Aspergillus spp. to anidulafungin, caspofungin, and micafungin: A head-to-head comparison using the CLSI M38-A2 broth microdilution method. J Clin Microbiol. 2009;47:3323–5.
Eschertzhuber S, Velik-Salchner C, Hoermann C, Hoefer D, Lass-Florl C. Caspofungin-resistant Aspergillus flavus after heart transplantation and mechanical circulatory support: a case report. Transplant Infect Dis. 2008;10:190–2.
Hernandez S, Lopez-Ribot JL, Najvar LK, McCarthy DI, Bocanegra R, Graybill JR. Caspofungin resistance in Candida albicans: correlating clinical outcome with laboratory susceptibility testing of three isogenic isolates serially obtained from a patient with progressive Candida esophagitis. Antimicrob Agents Chemother. 2004;48:1382–3.
Moudgal V, Little T, Boikov D, Vazquez JA. Multiechinocandin- and multiazole-resistant Candida parapsilosis isolates serially obtained during therapy for prosthetic valve endocarditis. Antimicrob Agents Chemother. 2005;49:767–9.
Laverdière M, Lalonde RG, Baril JG, Sheppard DC, Park S, Perlin DS. Progressive loss of echinocandin activity following prolonged use for treatment of Candida albicans oesophagitis. J Antimicrob Chemother. 2006;57:705–8.
Krogh-Madsen M, Arendrup MC, Heslet L, Knudsen JD. Amphotericin B and caspofungin resistance in Candida glabrata isolates recovered from a critically ill patient. Clin Infect Dis. 2006;42:938–44.
Thompson 3rd GR, Wiederhold NP, Vallor AC, Villareal NC, Lewis JS, Patterson TF. Development of caspofungin resistance following prolonged therapy for invasive candidiasis secondary to Candida glabrata infection. Antimicrob Agents Chemother. 2008;52:3783–5.
Garcia-Effron G, Kontoyiannis DP, Lewis RE, Perlin DS. Caspofungin-resistant Candida tropicalis strains causing breakthrough fungemia in patients at high risk for hematologic malignancies. Antimicrob Agents Chemother. 2008;52:4181–3.
Cleary JD, Garcia-Effron G, Chapman SW, Perlin DS. Reduced Candida glabrata susceptibility secondary to an FKS1 mutation developed during candidemia treatment. Antimicrob Agents Chemother. 2008;52:2263–5.
Perlin DS. Resistance to echinocandin-class antifungal drugs. Drug Resist Update. 2007;10:121–30.
Espinel-Ingroff A. Mechanisms of resistance to antifungal agents: Yeasts and filamentous fungi. Rev Iberoam Micol. 2008;25:101–6.
Gardiner RE, Souteropoulos P, Park S, Perlin DS. Characterization of Aspergillus fumigatus mutants with reduced susceptibility to caspofungin. Med Mycol. 2005;43 Suppl 1:S299–305.
Park S, Kelly R, Kahn JN, et al. Specific substitutions in the echinocandin target Fks1p account for reduced susceptibility of rare laboratory and clinical Candida spp. isolates. Antimicrob Agents Chemother. 2005;49:3264–73.
Rocha EM, Garcia-Effron G, Park S, Perlin DS. A Ser678Pro substitution in FKS1P confers resistance to echinocandin drugs in Aspergillus fumigatus. Antimicrob Agents Chemother. 2007;51:4174–6.
Garcia-Effron G, Katiyar SK, Park S, Edlind TD, Perlin DS. A naturally occurring proline-to-alanine amino acid change in FKS1p in Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis accounts for reduced echinocandin susceptibility. Antimicrob Agents Chemother. 2008;52:2305–12.
Katiyar SK, Edlind TD. Role for FKS1 in the intrinsic echinocandin resistance of Fusarium solani as evidenced by hybrid expression in Saccharomyces cerevisiae. Antimicrob Agents Chemother. 2009;53:1772–8.
Maligie MA, Selitrennikoff CP. Cryptococcus neoformans resistance to echinocandins: (1, 3)beta-glucan synthase activity is sensitive to echinocandins. Antimicrob Agents Chemother. 2005;49:2851–6.
Wiederhold NP, Kontoyiannis DP, Prince RA, Lewis RE. Attenuation of the activity of caspofungin at high concentrations against Candida albicans: possible role of cell wall integrity and calcineurin pathways. Antimicrob Agents Chemother. 2005;49:5146–8.
Wiederhold NP. Paradoxical echinocandin activity: a limited in vitro phenomenon? Med Mycol. 2009;47 Suppl 1:S369–75.
Stevens DA, Espiritu M, Parmar R. Paradoxical effect of caspofungin: reduced activity against Candida albicans at high drug concentrations. Antimicrob Agents Chemother. 2004;48:3407–11.
Stevens DA, White TC, Perlin DS, Selitrennikoff CP. Studies of the paradoxical effect of caspofungin at high drug concentrations. Diagn Microbiol Infect Dis. 2005;51:173–8.
Paderu P, Park S, Perlin DS. Caspofungin uptake is mediated by a high-affinity transporter in Candida albicans. Antimicrob Agents Chemother. 2004;48:3845–9.
Schuetzer-Muehlbauer M, Willinger B, Krapf G, Enzinger S, Presterl E, Kuchler K. The Candida albicans Cdr2p ATP-binding cassette (ABC) transporter confers resistance to caspofungin. Mol Microbiol. 2003;48:225–35.
Liu TT, Lee RE, Barker KS, Lee RE, Wei L, Homayouni R, et al. Genome-wide expression profiling of the response to azole, polyene, echinocandin, and pyrimidine antifungal agents in Candida albicans. Antimicrob Agents Chemother. 2005;49:2226–36.
Clemons KV, Espiritu M, Parmar R, Stevens DA. Assessment of the paradoxical effect of caspofungin in therapy of candidiasis. Antimicrob Agents Chemother. 2006;50:1293–7.
Lewis RE, Albert ND, Kontoyiannis DP. Comparison of the dose-dependent activity and paradoxical effect of caspofungin and micafungin in a neutropenic murine model of invasive pulmonary aspergillosis. J Antimicrob Chemother. 2008;61:1140–4.
Arikan S, Lozano-Chiu M, Paetznick V, Rex JH. In vitro synergy of caspofungin and amphotericin B against Aspergillus and Fusarium. Antimicrob Agents Chemother. 2002;46:245–7.
Stevens DA. Drug interaction studies of a glucan synthase inhibitor (LY 303366) and a chitin synthase inhibitor (Nikkomycin Z) for inhibition and killing of fungal pathogens. Antimicrob Agents Chemother. 2000;44:2547–8.
Perea S, Gonzalez G, Fothergill AW, Kirkpatrick WR, Rinaldi MG, Patterson TF. In vitro interaction of caspofungin acetate with voriconazole against clinical isolates of Aspergillus spp. Antimicrob Agents Chemother. 2002;46:3039–41.
Roling EE, Klepser ME, Wasson A, Lewis RE, Ernst EJ, Pfaller MA. Antifungal activities of fluconazole, caspofungin (MK0991), and anidulafungin (LY 303366) alone and in combination against Candida spp. and Crytococcus neoformans via time-kill methods. Diagn Microbiol Infect Dis. 2002;43:13–7.
Hossain MA, Reyes GH, Long LA, Mukherjee PK, Ghannoum MA. Efficacy of caspofungin combined with amphotericin B against azole-resistant Candida albicans. J Antimicrob Chemother. 2003;51:1427–9.
Manavathu EK, Alangaden GJ, Chandrasekar PH. Differential activity of triazoles in two-drug combinations with the echinocandin caspofungin against Aspergillus fumigatus. J Antimicrob Chemother. 2003;51:1423–5.
O’Shaughnessy EM, Meletiadis J, Stergiopoulou T, Demchok JP, Walsh TJ. Antifungal interactions within the triple combination of amphotericin B, caspofungin and voriconazole against Aspergillus species. J Antimicrob Chemother. 2006;58:1168–76.
Barchiesi F, Spreghini E, Fothergill AW, et al. Caspofungin in combination with amphotericin B against Candida glabrata. Antimicrob Agents Chemother. 2005;49:2546–9.
Cuenca-Estrella M, Gomez-Lopez A, Garcia-Effron G, et al. Combined activity in vitro of caspofungin, amphotericin B, and azole agents against itraconazole-resistant clinical isolates of Aspergillus fumigatus. Antimicrob Agents Chemother. 2005;49:1232–5.
Oliveira ER, Fothergill AW, Kirkpatrick WR, Coco BJ, Patterson TF, Redding SW. In vitro interaction of posaconazole and caspofungin against clinical isolates of Candida glabrata. Antimicrob Agents Chemother. 2005;49:3544–5.
Ganesan LT, Manavathu EK, Cutright JL, Alangaden GJ, Chandrasekar PH. In-vitro activity of nikkomycin Z alone and in combination with polyenes, triazoles or echinocandins against Aspergillus fumigatus. Clin Microbiol Infect. 2004;10:961–6.
Heyn K, Tredup A, Salvenmoser S, Muller FM. Effect of voriconazole combined with micafungin against Candida, Aspergillus, and Scedosporium spp. and Fusarium solani. Antimicrob Agents Chemother. 2005;49:5157–9.
Philip A, Odabasi Z, Rodriguez J, et al. In vitro synergy testing of anidulafungin with itraconazole, voriconazole, and amphotericin B against Aspergillus spp. and Fusarium spp. Antimicrob Agents Chemother. 2005;49:3572–4.
Kirkpatrick WR, Perea S, Coco BJ, Patterson TF. Efficacy of caspofungin alone and in combination with voriconazole in a guinea pig model of invasive aspergillosis. Antimicrob Agents Chemother. 2002;46:2564–8.
Petraitis V, Petraitiene R, Sarafandi AA, et al. Combination therapy in treatment of experimental pulmonary aspergillosis: synergistic interaction between an antifungal triazole and an echinocandin. J Infect Dis. 2003;187:1834–43.
Graybill JR, Bocanegra R, Gonzalez GM, Najvar LK. Combination antifungal therapy of murine aspergillosis: liposomal amphotericin B and micafungin. J Antimicrob Chemother. 2003;52:656–62.
MacCallum DM, Whyte JA, Odds FC. Efficacy of caspofungin and voriconazole combinations in experimental aspergillosis. Antimicrob Agents Chemother. 2005;49:3697–701.
Sionov E, Mendlovic S, Segal E. Efficacy of amphotericin B or amphotericin B-intralipid in combination with caspofungin against experimental aspergillosis. J Infect. 2006;53:131–9.
Barchiesi F, Spreghini E, Tomassetti S, Arzeni D, Giannini D, Scalise G. Comparison of the fungicidal activities of caspofungin and amphotericin B against Candida glabrata. Antimicrob Agents Chemother. 2005;49:4989–92.
Olson JA, Adler-Moore JP, Smith PJ, Proffitt RT. Treatment of Candida glabrata infection in immunosuppressed mice by using a combination of liposomal amphotericin B with caspofungin or micafungin. Antimicrob Agents Chemother. 2005;49:4895–902.
González GM, González G, Najvar LK, Graybill JR. Therapeutic efficacy of caspofungin alone and in combination with amphotericin B deoxycholate for coccidioidomycosis in a mouse model. J Antimicrob Chemother. 2007;60:1341–6.
Spellberg B, Fu Y, Edwards Jr JE, Ibrahim AS. Combination therapy with amphotericin B lipid complex and caspofungin acetate of disseminated zygomycosis in diabetic ketoacidotic mice. Antimicrob Agents Chemother. 2005;49:830–2.
Frank U, Greiner M, Engels I, Daschner FD. Effects of caspofungin (MK-0991) and anidulafungin (LY303366) on phagocytosis, oxidative burst and killing of Candida albicans by human phagocytes. Eur J Clin Microbiol Infect Dis. 2004;23:729–31.
Gil-Lamaignere C, Salvenmoser S, Hess R, Muller FM. Micafungin enhances neutrophil fungicidal functions against Candida pseudohyphae. Antimicrob Agents Chemother. 2004;48:2730–2.
Brummer E, Chauhan SD, Stevens DA. Collaboration of human phagocytes with LY 303366 for antifungal activity against Aspergillus fumigatus. J Antimicrob Chemother. 1999;43:491–6.
Chiller T, Farrokhshad K, Brummer E, Stevens DA. The interaction of human monocytes, monocyte-derived macrophages, and polymorphonuclear neutrophils with caspofungin (MK-0991), an echinocandin, for antifungal activity against Aspergillus fumigatus. Diagn Microbiol Infect Dis. 2001;39:99–103.
Choi JH, Brummer E, Stevens DA. Combined action of micafungin, a new echinocandin, and human phagocytes for antifungal activity against Aspergillus fumigatus. Microbes Infect. 2004;6:383–9.
Soustre J, Rodier MH, Imbert-Bouyer S, Daniault G, Imbert C. Caspofungin modulates in vitro adherence of Candida albicans to plastic coated with extracellular matrix proteins. J Antimicrob Chemother. 2004;53:522–5.
Kuhn DM, George T, Chandra J, Mukherjee PK, Ghannoum MA. Antifungal susceptibility of Candida biofilms: unique efficacy of amphotericin B lipid formulations and echinocandins. Antimicrob Agents Chemother. 2002;46:1773–80.
Bachmann SP, VandeWalle K, Ramage G, Patterson TF, Wickes BL, Graybill JR, et al. In vitro activity of caspofungin against Candida albicans biofilms. Antimicrob Agents Chemother. 2002;46:3591–6.
Ramage G, VandeWalle K, Bachmann SP, Wickes BL, Lopez-Ribot JL. In vitro pharmacodynamic properties of three antifungal agents against preformed Candida albicans biofilms determined by time-kill studies. Antimicrob Agents Chemother. 2002;46:3634–6.
Ernst ME, Klepser ME, Wolfe EJ, Pfaller MA. Antifungal dynamics of LY 303366, an investigational echinocandin B analog, against Candida spp. Diagn Microbiol Infect Dis. 1996;26:125–31.
Ernst EJ, Klepser ME, Ernst ME, Messer SA, Pfaller MA. In vitro pharmacodynamic properties of MK-0991 determined by time-kill methods. Diagn Microbiol Infect Dis. 1999;33:75–80.
Ernst EJ, Roling EE, Petzold CR, Keele DJ, Klepser ME. In vitro activity of micafungin (FK-463) against Candida spp.: microdilution, time-kill, and postantifungal-effect studies. Antimicrob Agents Chemother. 2002;46:3846–53.
Petraitis V, Petraitiene R, Groll AH, et al. Comparative antifungal activity of the echinocandin micafungin against disseminated candidiasis and invasive pulmonary aspergillosis in persistently neutropenic rabbits. Antimicrob Agents Chemother. 2002;46:1857–69.
Manavathu EK, Ramesh MS, Baskaran I, Ganesan LT, Chandrasekar PH. A comparative study of the post-antifungal effect (PAFE) of amphotericin B, triazoles and echinocandins on Aspergillus fumigatus and Candida albicans. J Antimicrob Chemother. 2004;53:386–9.
Clancy CJ, Huang H, Cheng S, Derendorf H, Nguyen MH. Characterizing the effects of caspofungin on Candida albicans, Candida parapsilosis, and Candida glabrata isolates by simultaneous time-kill and postantifungal-effect experiments. Antimicrob Agents Chemother. 2006;50:2569–72.
Nguyen KT, Ta P, Hoang BT, et al. Anidulafungin is fungicidal and exerts a variety of postantifungal effects against Candida albicans, C. glabrata, C. parapsilosis, and C. krusei isolates. Antimicrob Agents Chemother. 2009;53:3347–52.
Groll AH, Mickiene D, Petraitiene R, et al. Pharmacokinetic and pharmacodynamic modeling of anidulafungin (LY303366): Reappraisal of its efficacy in neutropenic animal models of opportunistic mycoses using optimal plasma sampling. Antimicrob Agents Chemother. 2001;45:2845–55.
Louie A, Deziel M, Liu W, Drusano MF, Gumbo T, Drusano GL. Pharmacodynamics of caspofungin in a murine model of systemic candidiasis: importance of persistence of caspofungin in tissues to understanding drug activity. Antimicrob Agents Chemother. 2005;49:5058–68.
Andes D, Diekema DJ, Pfaller MA, Prince RA, Marchillo K, Ashbeck J, et al. In vivo pharmacodynamic characterization of anidulafungin in a neutropenic murine candidiasis model. Antimicrob Agents Chemother. 2008;52:539–50.
Andes DR, Diekema DJ, Pfaller MA, Marchillo K, Bohrmueller J. In vivo pharmacodynamic target investigation for micafungin against Candida albicans and C. glabrata in a neutropenic murine candidiasis model. Antimicrob Agents Chemother. 2008;52:3497–503.
Wiederhold NP, Kontoyiannis DP, Chi J, Prince RA, Tam VH, Lewis RE. Pharmacodynamics of caspofungin in a murine model of invasive pulmonary aspergillosis: Evidence of concentration-dependent activity. J Infect Dis. 2004;190:1464–71.
Kartsonis N, Killar J, Mixson L, et al. Caspofungin susceptibility testing of isolates from patients with esophageal candidiasis or invasive candidiasis: relationship of MIC to treatment outcome. Antimicrob Agents Chemother. 2005;49:3616–23.
Pfaller MA, Diekema DJ, Ostrosky-Zeichner L, et al. Correlation of MIC with outcome for Candida species tested against caspofungin, anidulafungin, and micafungin: analysis and proposal for interpretive MIC breakpoints. J Clin Microbiol. 2008;46:2620–9.
Clinical and Laboratory Standards Institute (CLSI). Reference method for broth dilution antifungal susceptibility testing of yeasts; Approved standard – third edition; CLSI document M27-A3(28). 2008. Clinical and laboratory Standards Institute, Pennsylvania, USA.
Rodriguez-Tudela JL, Arendrup MC, Barchiesi F, et al. EUCAST definitive document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. ClinMicrobiol Infect. 2008;14:398–405.
Rodriguez-Tudela JL, Donnelly JP, Pfaller MA, et al. Statistical analyses of correlation between fluconazole MICs for Candida spp. assessed by standard methods set forth by the European Committee on Antimicrobial Susceptibility Testing (E.Dis. 7.1) and CLSI (M27-A2). J ClinMicrobiol. 2007;45:109–11.
Arendrup MC, Garcia-Effron G, Lass-Flörl C, et al. Susceptibility testing of Candida species to echinocandins: comparison of EUCAST EDef 7.1, CLSI M27-A3, Etest, disk diffusion and agar-dilution using RPMI and IsoSensitest medium. Antimicrob Agents Chemother. 2010;54:426–39.
Dowell JA, Knebel W, Ludden T, Stogniew M, Krause D, Henkel T. Population pharmacokinetic analysis of anidulafungin, an echinocandin antifungal. J Clin Pharmacol. 2004;44:590–8.
Dowell JA, Stogniew M, Krause D, Damle B. Anidulafungin does not require dosage adjustment in subjects with varying degrees of hepatic or renal impairment. J Clin Pharmacol. 2007;47:461–70.
Benjamin Jr DK, Driscoll T, Seibel NL, et al. Safety and pharmacokinetics of intravenous anidulafungin in children with neutropenia at high risk for invasive fungal infections. Antimicrob Agents Chemother. 2006;50:632–8.
Krause DS, Reinhardt J, Vazquez JA, et al. Phase 2, randomized, dose-ranging study evaluating the safety and efficacy of anidulafungin in invasive candidiasis and candidemia. Antimicrob Agents Chemother. 2004;48:2021–4.
Krause DS, Simjee AE, van Rensburg C, et al. A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis. Clin Infect Dis. 2004;39:770–5.
Reboli AC, Rotstein C, Pappas PG, et al. Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med. 2007;356:2472–82.
Vazquez JA, Schranz JA, Clark K, Goldstein BP, Reboli A, Fichtenbaum C. A phase 2, open-label study of the safety and efficacy of intravenous anidulafungin as a treatment for azole-refractory mucosal candidiasis. J Acquir Immune Defic Syndr. 2008;48:304–9.
Ecalta™ Summary of Product Characteristics. European Medicines Agency. 2009. http://www.emea.europa.eu/humandocs/Humans/EPAR/ecalta/ecalta.htm. Accessed 23 July 2009.
Eraxis™ U.S. Prescribers Information. U.S. Food and Drug Administration. 2006. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction = Search.Label_ApprovalHistory. Accessed 17 Feb 2006.
Dowell JA, Stogniew M, Krause D, Henkel T, Weston IE. Assessment of the safety and pharmacokinetics of anidulafungin when administered with cyclosporine. J Clin Pharmacol. 2005;45:227–33.
Dowell JA, Schranz J, Baruch A, Foster G. Safety and pharmacokinetics of coadministered voriconazole and anidulafungin. J Clin Pharmacol. 2005;45:1373–82.
Dowell JA, Stogniew M, Krause D, Henkel T, Damle B. Lack of pharmacokinetic interaction between anidulafungin and tacrolimus. J Clin Pharmacol. 2007;47:305–14.
Neely M, Jafri HS, Seibel N, et al. Pharmacokinetics and safety of caspofungin in older infants and toddlers. Antimicrob Agents Chemother. 2009;53:1450–6.
Sáez-Llorens X, Macias M, Maiya P, et al. Pharmacokinetics and safety of caspofungin in neonates and infants less than 3 months of age. Antimicrob Agents Chemother. 2009;53:869–75.
Villanueva A, Gotuzzo E, Arathoon EG, et al. A randomized double-blind study of caspofungin versus fluconazole for the treatment of esophageal candidiasis. Am J Med. 2002;113:294–9.
Stone JA, Holland SD, Wickersham PJ, et al. Single- and multiple-dose pharmacokinetics of caspofungin in healthy men. Antimicrob Agents Chemother. 2002;46:739–45.
Sandhu P, Lee W, Xu X, et al. Hepatic uptake of the novel antifungal agent caspofungin. Drug Metab Dispos. 2005;33:676–82.
Sandhu P, Xu X, Bondiskey PJ, et al. Disposition of caspofungin, a novel antifungal agent, in mice, rats, rabbits, and monkeys. Antimicrob Agents Chemother. 2004;48:1272–80.
Balani SK, Xu X, Arison BH, et al. Metabolites of caspofungin acetate, a potent antifungal agent, in human plasma and urine. Drug Metab Dispos. 2000;28:1274–8.
Mistry GC, Migoya E, Deutsch PJ, et al. Single- and multiple-dose administration of caspofungin in patients with hepatic insufficiency: Implications for safety and dosing recommendations. J Clin Pharmacol. 2007;47:951–61.
Villanueva A, Arathoon EG, Gotuzzo E, Berman RS, DiNubile MJ, Sable CA. A randomized double-blind study of caspofungin versus amphotericin for the treatment of candidal esophagitis. Clin Infect Dis. 2001;33:1529–35.
Arathoon EG, Gotuzzo E, Noriega LM, Berman RS, DiNubile MJ, Sable CA. Randomized, double-blind, multicenter study of caspofungin versus amphotericin B for treatment of oropharyngeal and esophageal candidiasis. Antimicrob Agents Chemother. 2002;46:451–7.
Kartsonis N, DiNubile MJ, Bartizal K, Hicks PS, Ryan D, Sable CA. Efficacy of caspofungin in the treatment of esophageal candidiasis resistant to fluconazole. J Acquir Immune Defic Syndr. 2002;3:183–7.
Mora-Durate J, Betts R, Rotstein C, et al. Comparison of caspofungin and amphotericin B for invasive candidiasis. N Engl J Med. 2002;347:2020–9.
Pappas PG, Rotstein CM, Betts RF, et al. Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. Clin Infect Dis. 2007;45:883–93.
Betts RF, Nucci M, Talwar D, et al. A multicenter, double-blind trial of a high-dose caspofungin treatment regimen versus a standard caspofungin treatment regimen for adult patients with invasive candidiasis. Clin Infect Dis. 2009;48:1676–84.
Cornely OA, Lasso M, Betts R, et al. Caspofungin for the treatment of less common forms of invasive candidiasis. J Antimicrob Chemother. 2007;60:363–9.
Betts R, Glasmacher A, Maertens J, et al. Efficacy of caspofungin against invasive Candida or invasive Aspergillus infections in neutropenic patients. Cancer. 2006;106:466–73.
Maertens J, Raad I, Petrikkos G, et al. Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy. Clin Infect Dis. 2004;39:1563–71.
Viscoli C, Herbrecht R, Akan H, et al. An EORTC Phase II study of caspofungin as first-line therapy of invasive aspergillosis in haematological patients. J Antimicrob Chemother. 2009;64:1274–81.
Herbrecht R, Maertens J, Biala L, et al. Caspofungin as first line therapy of invasive aspergillosis in allogeneic hematopoietic stem cell transplant recipients: A study of the EORTC Infectious Diseases Group. Program and Abstracts of the 49th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, DC: abst. M-2168, p. 674 (2009).
Marr KA, Boeckh M, Carter RA, Kim HW, Corey L. Combination antifungal therapy for invasive aspergillosis. Clin Infect Dis. 2004;39:797–802.
Kontoyiannis DP, Hachem R, Lewis RE, et al. Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies. Cancer. 2003;98:292–9.
Maertens J, Glasmacher A, Herbrecht R, et al. Multicenter, noncomparative study of caspofungin in combination with other antifungals as salvage therapy in adults with invasive aspergillosis. Cancer. 2006;107:2888–97.
Caillot D, Thiébaut A, Herbrecht R, et al. Liposomal amphotericin B in combination with caspofungin for invasive aspergillosis in patients with hematologic malignancies: a randomized pilot study (Combistrat trial). Cancer. 2007;110:2740–6.
Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis. 2008;47:364–71.
Walsh TJ, Teppler H, Donowitz GR, et al. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med. 2004;351:1391–402.
Mattiuzzi GN, Alvarado G, Giles FJ, et al. Open-label, randomized comparison of itraconazole versus caspofungin for prophylaxis in patients with hematologic malignancies. Antimicrob Agents Chemother. 2006;50:143–7.
Maertens JA, Madero-Lopez L, Reilly AF, et al. A randomized, double-blind, multicenter study of caspofungin versus liposomal amphotericin B for empirical antifungal therapy in pediatric patients with persistent fever and neutropenia. Pediatr Infect Dis J. 2010;29(5):415–20.
Zaoutis TE, Jafri HS, Huang LM, et al. A prospective, multicenter study of caspofungin for the treatment of documented Candida or Aspergillus infections in pediatric patients. Pediatrics. 2009;123:877–84.
Odio CM, Araya R, Pinto LE, et al. Caspofungin therapy of neonates with invasive candidiasis. Pediatr Infect Dis J. 2004;23:1093–7.
Natarajan G, Lulic-Botica M, Rongkavilit C, Pappas A, Bedard M. Experience with caspofungin in the treatment of persistent fungemia in neonates. J Perinatol. 2005;25:770–7.
Odio CM, Castro CE, Vasques S, Lazo J, Herrera ML. Caspofungin therapy for neonates with invasive candidiasis cared for at intensive care units. In Program and Abstracts of the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, DC: abst. G-976, p. 270 (2007).
Cancidas™ U.S. Prescribers Information. U.S. Food and Drug Administration. 2009. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory. Accessed 26 June 2009.
Cancidas™ Summary of Product Characteristics. European Medicines Agency. 2009. http://www.emea.europa.eu/humandocs/Humans/EPAR/cancidas/cancidas.htm. Accessed 23 July 2009.
Cleary JD, Schwartz M, Rogers PD, de Mestral J, Chapman SW. Effects of amphotericin B and caspofungin on histamine expression. Pharmacotherapy. 2003;23:966–73.
Sable CA, Nguyen BY, Chodakewitz JA, DiNubile MJ. Safety and tolerability of caspofungin acetate in the treatment of fungal infections. Transpl Infect Dis. 2002;4:25–30.
Glasmacher A, Cornely OA, Orlopp K, et al. Caspofungin treatment in severely ill, immunocompromised patients: a case-documentation study of 118 patients. J Antimicrob Chemother. 2006;57:127–34.
Groll AH, Attarbaschi A, Schuster FR, et al. Treatment with caspofungin in immunocompromised paediatric patients: a multicentre survey. J Antimicrob Chemother. 2006;57:527–35.
Zaoutis T, Lehrnbecher T, Groll AH, et al. Safety experience with caspofungin in pediatric patients. Pediatr Infect Dis J. 2009;28:1132–5.
Marr KA, Hachem R, Papanicolaou G, et al. Retrospective study of the hepatic safety profile of patients concomitantly treated with caspofungin and cyclosporin A. Transpl Infect Dis. 2004;6:110–6.
Sanz-Rodriguez C, Lopez-Duarte M, Jurado M, et al. Safety of the concomitant use of caspofungin and cyclosporin A in patients with invasive fungal infections. Bone Marrow Transplant. 2004;34:13–20.
Stone JA, Migoya EM, Hickey L, et al. Potential for interactions between caspofungin and nelfinavir or rifampin. Antimicrob Agents Chemother. 2004;48:4306–14.
Colburn DE, Giles FJ, Oladovich D, Smith JA. In vitro evaluation of cytochrome P450-mediated drug interactions between cytarabine, idarubicin, itraconazole and caspofungin. Hematology. 2004;9:217–21.
Hiemenz J, Cagnoni P, Simpson D, et al. Pharmacokinetic and maximum tolerated dose study of micafungin in combination with fluconazole versus fluconazole alone for prophylaxis of fungal infections in adult patients undergoing a bone marrow or peripheral stem cell transplant. Antimicrob Agents Chemother. 2005;49:1331–6.
Tabata K, Katashima M, Kawamura A, Kaibara A, Tanigawara Y. Population pharmacokinetic analysis of micafungin in Japanese patients with fungal infections. Drug Metab Pharmacokinet. 2006;21:324–31.
Gumbo T, Hiemenz J, Ma L, Keirns JJ, Buell DN, Drusano GL. Population pharmacokinetics of micafungin in adult patients. Diagn Microbiol Infect Dis. 2008;60:329–31.
Hebert MF, Smith HE, Marbury TC, et al. Pharmacokinetics of micafungin in healthy volunteers, volunteers with moderate liver disease, and volunteers with renal dysfunction. J Clin Pharmacol. 2005;45:1145–52.
Hope WW, Seibel NL, Schwartz CL, et al. Population pharmacokinetics of micafungin in pediatric patients and implications for antifungal dosing. Antimicrob Agents Chemother. 2007;51:3714–9.
Hope WW, Mickiene D, Petraitis V, et al. The pharmacokinetics and pharmacodynamics of micafungin in experimental hematogenous Candida meningoencephalitis: implications for echinocandin therapy in neonates. J Infect Dis. 2008;197:163–71.
Kishino S, Ohno K, Shimamura T, Furukawatodo H. Optimal prophylactic dosage and disposition of micafungin in living donor liver recipients. Clin Transplant. 2004;18:676–80.
Seibel NL, Schwartz C, Arrieta A, et al. Safety, tolerability, and pharmacokinetics of micafungin (FK463) in febrile neutropenic pediatric patients. Antimicrob Agents Chemother. 2005;49:3317–24.
Heresi GP, Gerstmann DR, Reed MD, et al. The pharmacokinetics and safety of micafungin, a novel echinocandin, in premature infants. Pediatr Infect Dis J. 2006;25:1110–5.
Benjamin Jr DK, Smith PB, Arrieta A, et al. Safety and pharmacokinetics of repeat-dose micafungin in young infants. Clin Pharmacol Ther. 2010;87:93–9.
Smith PB, Walsh TJ, Hope W, et al. Pharmacokinetics of an elevated dosage of micafungin in premature neonates. Pediatr Infect Dis J. 2009;28:412–5.
Pettengell K, Mynhardt J, Kluyts T, Lau W, Facklam D, Buell D. FK463 South African Study Group. Successful treatment of oesophageal candidiasis by micafungin: a novel systemic antifungal agent. Aliment Pharmacol Ther. 2004;20:475–81.
de Wet N, Llanos-Cuentas A, Suleiman J, et al. A randomized, double-blind, parallel-group, dose-response study of micafungin compared with fluconazole for the treatment of esophageal candidiasis in HIV-positive patients. Clin Infect Dis. 2004;39:842–9.
de Wet NT, Bester AJ, Viljoen JJ, et al. A randomized, double blind, comparative trial of micafungin (FK463) vs. fluconazole for the treatment of oesophageal candidiasis. Aliment Pharmacol Ther. 2005;21:899–907.
Kuse ER, Chetchotisakd P, da Cunha CA, et al. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet. 2007;369:1519–27.
Ostrosky-Zeichner L, Kontoyiannis D, Raffalli J, et al. International, open-label, noncomparative, clinical trial of micafungin alone and in combination for treatment of newly diagnosed and refractory candidemia. Eur J Clin Microbiol Infect Dis. 2005;24:654–61.
Denning DW, Marr KA, Lau WM, et al. Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis. J Infect. 2006;53:337–49.
Kontoyiannis DP, Ratanatharathorn V, Young JA, et al. Micafungin alone or in combination with other systemic antifungal therapies in hematopoietic stem cell transplant recipients with invasive aspergillosis. Transpl Infect Dis. 2009;11:89–93.
van Burik JA, Ratanatharathorn V, Stepan DE, et al. Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation. Clin Infect Dis. 2004;39:1407–16.
Hiramatsu Y, Maeda Y, Fujii N, et al. Use of micafungin versus fluconazole for antifungal prophylaxis in neutropenic patients receiving hematopoietic stem cell transplantation. Int J Hematol. 2008;88:588–95.
Queiroz-Telles F, Berezin E, Leverger G, et al. Micafungin versus liposomal amphotericin B for pediatric patients with invasive candidiasis: substudy of a randomized double-blind trial. Pediatr Infect Dis J. 2008;27:820–6.
Sirohi B, Powles RL, Chopra R, et al. A study to determine the safety profile and maximum tolerated dose of micafungin (FK463) in patients undergoing haematopoietic stem cell transplantation. Bone Marrow Transplant. 2006;38:47–51.
Cornely O, Maddison P, Ullmann JA. Pooled analysis of safety for micafungin. In: Abstracts of the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology: abst. M 1175, p. 444 (2007).
Mycamine™ Summary of Product Characteristics. European Medicines Agency. 2008. http://www.emea.europa.eu/humandocs/Humans/EPAR/mycamine/mycamine.htm. Acessed 31 Oct 2008.
Niwa T, Inoue-Yamamoto S, Shiraga T, Takagi A. Effect of antifungal drugs on cytochrome P450 (CYP) 1A2, CYP2D6, and CYP2E1 activities in human liver microsomes. Biol Pharm Bull. 2005;28:1813–6.
Niwa T, Shiraga T, Takagi A. Effect of antifungal drugs on cytochrome P450 (CYP) 2C9, CYP2C19, and CYP3A4 activities in human liver microsomes. Biol Pharm Bull. 2005;28:1805–8.
Sakaeda T, Iwaki K, Kakumoto M, et al. Effect of micafungin on cytochrome P450 3A4 and multidrug resistance protein 1 activities, and its comparison with azole antifungal drugs. J Pharm Pharmacol. 2005;57:759–64.
Mycamine™ U.S. Prescribers Information. U.S. Food and Drug Administration. 2008. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory. Accessed 22 Jan 2008.
Hebert MF, Blough DK, Townsend RW, et al. Concomitant tacrolimus and micafungin pharmacokinetics in healthy volunteers. J Clin Pharmacol. 2005;45:1018–24.
Keirns J, Sawamoto T, Holum M, Buell D, Wisemandle W, Alak A. Steady-state pharmacokinetics of micafungin and voriconazole after separate and concomitant dosing in healthy adults. Antimicrob Agents Chemother. 2007;51:787–90.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Groll, A.H., Schrey, D., Walsh, T.J. (2011). Echinocandins. In: Kauffman, C., Pappas, P., Sobel, J., Dismukes, W. (eds) Essentials of Clinical Mycology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6640-7_6
Download citation
DOI: https://doi.org/10.1007/978-1-4419-6640-7_6
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-6639-1
Online ISBN: 978-1-4419-6640-7
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)