Nuevos antifúngicos: Las equinocandinas

Abstract

The lipopeptide family known as echinocandins emerge as the new “antifungal penicillins”, because their ability to destroy the fungal cell wall as they inhibit glucan synthesis, the main component of fungal structure. Echinocandins are fungicidal in vitro and in vivo against most Candida species and fungistatic against Aspergillus sp, without antifungal activity over mammal cells. Three drugs are representative of this class; caspofungin, micafungin and anidulafungin, the two first have been licensed for human use. Their optimal security profile, with low incidence and severity of adverse effects, kind posology and few interactions with other drugs, represent noticeable advantages for modern antifungal therapy. They have similar clinical efficacy as amphotericin B, without its toxicity, which besides the absence of antagonism with other antifungal drugs, allows to suggest that combined antifungal therapy could represent a new standard for the management of the feared invasive aspergillosis. Key