Rezafungin is a novel, once-weekly
echinocandin antifungal being developed for the first-line treatment of candidemia and invasive candidiasis as well as for the prophylaxis of invasive fungal infections in patients undergoing allogeneic blood and marrow transplantation, for which no new therapies have been approved in over 13 years.
Cidara is currently advancing its novel
echinocandin antifungal, rezafungin acetate, in a Phase 3 clinical trial for the first-line treatment of candidemia and/or invasive candidiasis (ReSTORE).
Echinocandin susceptibility profile of fluconazole resistant Candida species isolated from blood stream infections.
Antimicrobial Activities of New Indole Derivatives Containing 1,2,4-Triazole, 1,3,4-Thiadiazole and Carbothioamide/1,2,4-Triazol, 1,3,4-Tiyadiazol ve Karbotiyoamit Iceren Yeni Indol Turevlerinin Antimikrobiyal Aktiviteleri In addition to CVC removal and its timing, the following variables were analyzed as potential factors associated with 30-day mortality: age, sex, APACHE II score (calculated on the day of the incident candidemia), concomitant medical conditions (cancer, diabetes, renal failure, cardiac disease, lung disease, cirrhosis), recent surgery (of any type requiring any anesthesia other than local anesthesia within three months prior to the incident candidemia), dialysis, mucositis, neutropenia (<500neutrophils/[mm.sup.3]), receipt of corticosteroids or total parenteral nutrition within 14 days before the incident candidemia, Candida species, and antifungal drug class (azole, amphotericin B or
echinocandin).
Activity of contemporary antifungal agents, including the novel
echinocandin anidulafungin, tested against Candida spp., Cryptococcus spp.
Overall, 28 (30%) were resistant to fluconazole, 20 (22%) to amphotericin B, one (1%) to anidulafungin (an
echinocandin), and one to both amphotericin B and anidulafungin.
Therapeutic Options in the Management of
Echinocandin Resistant Candida Species
Echinocandin (caspofungin, anidulafungin, micafungin) or fluconazole is recommended for empirical antifungal therapy.
These include the polyene group that encompasses amphotericin B deoxycholate and its lipid formulations (liposomal amphotericin B, amphotericin B lipid complex, and amphotericin B cholesteryl sulfate complex); the nucleoside analogue flucytosine; the triazoles which include fluconazole and voriconazole; and the most recently developed
echinocandin class, which includes caspofungin, micafungin, and anidulafungin.
Empiric combination therapy with an azole +
echinocandin was chosen to cover possible endemic fungi and invasive aspergillosis.
parapsilosis (a Candida species with higher intrinsic
echinocandin MIC values) RZF was 8- to >1,024-fold more potent than TER against all strains tested, in both media types (median 64-fold more potent).
Caspofungin, an
echinocandin drug, is used clinically for the invasive fungal disease.
