Caspofungin: the first representative of a new antifungal class

Caspofungin (MK-0991; L-743,872) belongs to the echinocandin family, a new class of antifungal agents that act on the fungal cell wall by inhibiting glucan synthesis. Data in vitro, and experimental studies, have demonstrated that caspofungin has antifungal activity against yeasts of the genus Candi...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2003-03, Vol.51 (3), p.513-521
Main Authors: Letscher-Bru, Valérie, Herbrecht, Raoul
Format: Article
Language:English
Subjects:
Animals
Anti-Bacterial Agents - chemistry
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Antifungal Agents - chemistry
Antifungal Agents - pharmacology
Antifungal Agents - therapeutic use
Biological and medical sciences
candidaemia
Caspofungin
Clinical Trials as Topic - statistics & numerical data
Drug Therapy, Combination
echinocandin
Echinocandins
Humans
invasive aspergillosis
Lipopeptides
Medical sciences
Mycoses - drug therapy
Mycoses - physiopathology
oesophageal candidiasis
oropharyngeal candidiasis
Peptides
Peptides, Cyclic
Pharmacology. Drug treatments
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Summary:Caspofungin (MK-0991; L-743,872) belongs to the echinocandin family, a new class of antifungal agents that act on the fungal cell wall by inhibiting glucan synthesis. Data in vitro, and experimental studies, have demonstrated that caspofungin has antifungal activity against yeasts of the genus Candida (including isolates resistant to azoles and amphotericin B), several species of filamentous fungi, including Aspergillus, and certain dimorphic fungi, such as Histoplasma, Blastomyces and Coccidioides. In vitro and in animals, caspofungin shows additive or synergic antifungal activity with amphotericin B and triazoles. It also possesses activity against Pneumocystis carinii. Clinical trials have shown caspofungin to be well tolerated and effective in invasive aspergillosis in patients refractory or intolerant to standard treatment (45% favourable responses), in oropharyngeal and oesophageal candidiasis (67–93% favourable responses with an efficacy similar to those of amphotericin B and fluconazole), and in invasive candidiasis with efficacy equivalent to that of amphotericin B, and better tolerability. The results of these first clinical trials were promising, and led to the approval of caspofungin for invasive aspergillosis after failure of, or intolerance to, standard therapy. Further studies are required to define the exact role of caspofungin in the antifungal armamentarium.
ISSN:0305-7453
1460-2091
1460-2091
DOI:10.1093/jac/dkg117