ABSTRACT
The echinocandin antifungals are large lipoprotein molecules that inhibit (1,3)-beta-D-glucan synthase blocking fungal cell wall synthesis. This results in fungistatic and fungicidal effects against Aspergillus spp. and Candida spp., respectively. There are currently three echinocandins in clinical use: caspofungin, micafungin, and anidulafungin. These agents are administered intravenously, and their pharmacokinetics allow once daily dosing. The favorable safety profile of these agents makes them attractive options for pediatric patients as well as patients with multiple comorbidities. In this chapter, we discuss the spectrum of activity, resistance, pharmacokinetics and dynamics, safety, dosing, and clinical efficacy of the echinocandins and highlight the future directions of therapy.
