Micafungin, a potent inhibitor of 1,3-beta-D-glucan synthase, has become the second available agent in the echinocandins class that is approved for use in clinical practice. This agent shares with caspofungin an identical spectrum of in vitro activity against Candida albicans, non-albicans species of Candida, and Aspergillus species, as well as several but not all pathogenic molds. If anything,...

Case presentation: We report a rare case of fungal pericardial effusion caused by the recently recognized multidrug-resistant Candida auris, which was cultured from pericardial fluid, blood, bronchoalveolar lavage and urine of a chronic liver disease patient while on empiric fluconazole therapy. The yeast was misidentified as Candida haemulonii by the VITEK2 commercial identification system, an...

OBJECTIVES To determine whether systemic administration of voriconazole and caspofungin causes ototoxicity. METHODS This study was conducted on 32 healthy male Wistar albino rats. The baseline auditory brainstem response (ABR) thresholds of all animals were obtained under general anesthesia. Then, the rats were randomly divided into 4 groups (groups I-IV), each group consisting of 8 rats. Rat...

Sir—Cholangitis due to candidiasis is a rare infection in patients without predisposing factors, but it has become an increasingly recognized complication in patients who have received a liver transplant [1]. After liver transplantation is performed, strictures may develop in the extrahepatic biliary tract and lead to secondary sludge formation, which can predispose a patient to recurrent chola...

In the June 2010 issue of Antimicrobial Agents and Chemotherapy, Wang et al. (8) reported a meta-analysis of the safety of systemic antifungals based on published study data. Among other aspects, the authors analyzed the rates of treatment discontinuation. This analysis appears to be biased by a methodological flaw. In Table 3, the authors use the term “treatment discontinuation due to adverse ...

BACKGROUND This study is a pre-planned country-specific subanalysis of results in Germany from a multinational multicenter registry to prospectively assess real-world experience with caspofungin administered for treatment of proven or probable invasive aspergillosis (IA). METHODS Data from patients treated with caspofungin for a single episode of IA were collected. Effectiveness was determine...

Increasing rates of invasive candidiasis caused by non-albicans Candida species have been reported worldwide. Particular concerns have been raised for C. parapsilosis because of reduced in vitro susceptibility to echinocandins. We identified 212 patients with invasive candidiasis due to non-albicans Candida species (>or=5 cases per species) in 5 clinical trials of caspofungin monotherapy from t...

The concentration-dependent effects of echinocandins on the metabolic activity of Aspergillus spp. were comparatively studied by using nongerminated and germinated conidia. The susceptibilities of 11 Aspergillus fumigatus, 8 A. terreus and 8 A. flavus isolates to caspofungin, micafungin, and anidulafungin were studied by a CLSI (formerly NCCLS) M38-A broth microdilution-based method. After 48 h...

OBJECTIVES The aim of the present study was to compare, in vitro and in vivo, the effects of caspofungin, micafungin and anidulafungin against Candida parapsilosis complex isolates. METHODS In vitro activities of all three echinocandins were assessed against C. parapsilosis sensu stricto (n = 4), Candida orthopsilosis (n = 4) and Candida metapsilosis (n = 3) using broth microdilution suscepti...

Echinocandins, such as caspofungin, are commonly used to treat candidemia and aspergillosis. Success rates for candidemia treatment are approximately 70%. Dose optimization may further help improve these success rates, given that the microbial effect of these agents is concentration dependent. There are conflicting data as regards the effect of weight and/or obesity on caspofungin drug concentr...