Antifungal Echinocandins  - Antibiotics Class Overview


Mechanism: Inhibit glucan synthesis in fungal cell wall by blocking beta 1,3 D-glucan synthase à fungicidal agent.  All are IV only.
Cidal vs Candida -> Drug of choice for severe Candida infections – covers virtually all species including Fluconazole-resistant C.krusei and C.glabrata.  But higher MICs in vitro for C.parapsilosis (commonly associated with TPN) – unclear significance as it still usually works clinically.  Also, rare reports of resistance in C.lusitaniae, C.guilliermondii.
Static vs Aspergillus -> 2nd-line for Aspergillus infections (often as combination therapy or as salvage therapy, never as initial monotherapy)
All Echinocandins lack activity vs Cryptococcus, Zygomycetes, and Fusarium.
 1. Caspofungin
 2. Micafungin
 3. Anidulafungin


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