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Candidiasis: New agents for invasive infections
The Clinical Advisor, 10/06/09

Sherman C – These agents – the echinocandins caspofungin, anidulafungin, and micafungin – are essentially reserved for candidemia and other invasive forms of candidiasis. The Guidelines also incorporate new data on the treatment of mucocutaneous disease and on the prevention of invasive disease in high–risk patients. The Guidelines recommend an echinocandin as initial therapy for candidemia in neutropenic patients and in non–neutropenic individuals who have moderately severe to severe illness or had recent azole exposure. If the organism is later found likely to be fluconazole–susceptible (e.g., Candida albicans), the Guidelines recommend a switch to fluconazole once the patient is clinically stable. The recommendations for empirical treatment of suspected invasive candidiasis are similar. Although antifungal prophylaxis remains an area of controversy, new data have strengthened recommendations for its use under specified circumstances in patients who are judged to be at high risk of invasive candidiasis.

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