Echinocandins — First-Choice or First-Line Therapy for Invasive Candidiasis?

Abstract

For three decades, antifungal chemotherapy was dominated by a single effective fungicidal agent: amphotericin B deoxycholate. However, concern about toxicity profoundly limited its use. The 1990s saw the introduction of the triazoles, such as fluconazole, and although these drugs were not more effective than amphotericin, their safety profile allowed their clinical use as prophylactic and empirical agents. As fear of their toxic effects subsided, inappropriate and unvalidated use appeared — and as expected, acquired microbial resistance emerged as an important issue.The newest class of antifungal agents was heralded by the approval of caspofungin for candidiasis in 2002, and already . . .