[Potential of anidulafungin in hematological patients].

Abstract

Until relatively recently, the treatment available for invasive fungal infections in hematological patients consisted of amphotericin B and azoles. Each of these groups had limitations and secondary effects. The echinocandins are a new class of antifungal agent that has shown promising results in the treatment of numerous invasive fungal infections. Anidulafungin is a new echinocandin that, in addition to showing potent in vitro activity against Aspergillus spp. and Candida spp. (including fluconazole- and amphotericin B-resistant microorganisms), also provides some advantages over other candins. In humans, these drugs are degraded through biotransformation rather than a metabolic process. No drug interactions have been found. In hematological patients, anidulafungin would play a "potential" role as empirical therapy in febrile neutropenia, as is the case of caspofungin. Given the epidemiology of Candida infection in these patients, anidulafungin could be used as initial therapy in candidemia before starting treatment with oral flucozanole, if indicated by the fungigram. This drug would also be indicated in the treatment of invasive Aspergillus spp. infections in patients with hepatic or renal insufficiency or in those taking concomitant medications. The available in vitro studies also suggest an important role for this drug in combinations of antifungal agents. Given the excellent safety profile and absence of interactions of anidulafungin, this drug will undoubtedly be of great utility in the management of difficult-to-treat mycotic infections in hematological patients.

• Authors: Lourdes Vázquez López, Isabel Ruiz Camps
• Journal: Enfermedades infecciosas y microbiologia clinica (Enferm Infecc Microbiol Clin) Vol. 26 Suppl 14 Pg. 44-50 (Dec 2008) ISSN: 0213-005X [Print] Spain
• Vernacular Title: Potencial de anidulafungina en el paciente hematológico.
• PMID: 19572434 (Publication Type: Journal Article, Review)

Chemical References

• Antifungal Agents
• Antineoplastic Agents
• Azoles
• Echinocandins
• Amphotericin B
• Anidulafungin

Topics

• Amphotericin B (administration & dosage, therapeutic use)
• Anidulafungin
• Animals
• Antifungal Agents (adverse effects, pharmacokinetics, therapeutic use)
• Antineoplastic Agents (adverse effects)
• Aspergillosis (drug therapy, epidemiology, etiology)
• Azoles (administration & dosage, therapeutic use)
• Candidiasis (drug therapy, epidemiology, etiology)
• Clinical Trials as Topic (statistics & numerical data)
• Drug Evaluation, Preclinical
• Drug Therapy, Combination
• Echinocandins (administration & dosage, adverse effects, pharmacokinetics, therapeutic use)
• Fungemia (drug therapy, epidemiology, etiology)
• Hematologic Diseases (complications, drug therapy)
• Hematologic Neoplasms (complications, drug therapy)
• Humans
• Inactivation, Metabolic
• Kidney Diseases (complications)
• Liver Diseases (complications)
• Mice
• Neutropenia (chemically induced, complications)
• Risk Factors