BDH Klinik Greifswald GmbH, Germany.
Eur J Med Res. 2011 Apr 28;16(4):167-79. doi: 10.1186/2047-783x-16-4-167.
Working by a distinct cell wall-specific mechanism of action, the echinocandin class of antifungals has substantially expanded the range of available treatments for invasive Candida infections. Anidulafungin, caspofungin and micafungin were investigated versus drugs from earlier antifungal classes in large clinical trials that demonstrated their excellent clinical and microbiological efficacy in the primary treatment of invasive candidiasis. Therefore, and supported by a number of favourable pharmacological characteristics, the echinocandins rapidly became established in guidelines and clinical practice as primary treatment options for moderately to severely ill patients with invasive candidiasis. This article reviews the relevant clinical evidence that forms the basis for the use of echinocandins in the management of invasive candidiasis, and discusses their current role in the context of recent guideline recommendations and treatment optimization strategies.
棘白菌素类抗真菌药通过独特的细胞壁作用机制发挥作用，大大扩展了侵袭性念珠菌感染的治疗选择范围。在大型临床试验中，对棘白菌素类药物与早期抗真菌药物进行了比较，结果表明它们在侵袭性念珠菌病的初始治疗中具有极好的临床和微生物学疗效。因此，基于一些有利的药理学特性，棘白菌素类药物迅速在指南和临床实践中确立为中重度侵袭性念珠菌病患者的初始治疗选择。本文回顾了用于指导棘白菌素类药物治疗侵袭性念珠菌病的相关临床证据，并讨论了它们在最近的指南推荐和治疗优化策略背景下的当前作用。
