Journal of Antimicrobial Chemotherapy (2002) 49, 889-891
© 2002 The British Society for Antimicrobial Chemotherapy
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Echinocandins: a new class of antifungal
Education and Research Centre, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT and University of Manchester, Manchester M13 9PL, UK
The echinocandins represent the first new antifungal drug class introduced for more than 15 years. They inhibit the synthesis of ß-D-glucan in fungal cell walls. Their strengths include low toxicity, rapid fungicidal activity against most isolates of Candida spp. and predictable favourable kinetics allowing once a day dosing. In addition to Candida spp., their inhibitory spectrum includes Aspergillus spp. and Pneumocystis carinii, but not Cryptococcus neoformans.
The first licensed echinocandin product is caspofungin acetate (Cancidas; Merck); subsequent members of the class likely to be licensed include micafungin (Fujisawa) and anidulafungin (Versicor). The initial licensure of caspofungin, however, is for the treatment of patients with invasive aspergillosis refractory to amphotericin B (in its various formulations) and/or itraconazole. In fact, the very strength of these data, from incontrovertible cases of invasive aspergillosis with no licensed therapeutic options left, initially enabled the naturally
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