Drug Review on Echinocandins

Echinocandins are the newer addition to antifungal agents effective for Amphotericin B-resistant or fluconazole- and itraconazole-resistant Candida glabrata species. Echinocandins have fungicidal activity against multiple Candida species, including C. albicans, C. dubliniensis, C. glabrata, and C. krusei and fungistatic activity against Aspergillus species. These drugs inhibit the synthesis of the enzyme 1,3-β glucan synthase which is necessary for the synthesis of an essential component of the cell wall of several fungi. Because of Echinocandins poor oral bioavailability, these drugs can only be administered intravenously. Echinocandins that currently are available include Caspofungin, Micafungin, and Anidulafungin. All three drugs are approved for the treatment of oesophageal candidiasis, candidaemia and other select forms of invasive candidiasis. Only micafungin is used to prevent Candida fungal infections in stem cell transplant patients, whereas caspofungin is approved for empirical therapy of febrile neutropenia. Caspofungin has a slightly higher potential for adverse effects/drug-drug interactions among these enchiniocandins and least observed for Anidulafungin. Due to the limited toxicity and a favorable drug-drug interactions profile make Echinocandins treatment as a viable alternative to conventional treatment.