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Revista Iberoamericana de Micologia Jun 2008Anidulafungin is a new echinocandin antifungal agent which inhibits beta-1,3-D-glucan synthase and disrupts fungal cell-wall synthesis. It has marked antifungal activity... (Review)
Review
Anidulafungin is a new echinocandin antifungal agent which inhibits beta-1,3-D-glucan synthase and disrupts fungal cell-wall synthesis. It has marked antifungal activity against Candida spp. and Aspergillus spp., including amphotericin B and triazole resistant strains. Due to the limited oral availability, anidulafungin in clinical use is available for parenteral administration only. Elimination of anidulafungin takes place via slow non-enzymatic degradation to inactive metabolites. Less than 10% and 1% of the initially administered drug is excreted unchanged into feces and urine, respectively. It does not require dosage adjustment in subjects with hepatic or renal impairment established. Anidulafungin is generally well tolerated. Adverse events appear not to be dose or infusion related. The most common treatment related adverse events are phlebitis, headache, nausea, vomiting and pyrexia. The lack of interactions with tacrolimus, cyclosporine and corticosteroids and its limited toxicity profile places anidulafungin as an attractive new option for the treatment of invasive fungal infections especially in transplant patients.
Topics: Anidulafungin; Antifungal Agents; Echinocandins; Humans; Mycoses
PubMed: 18473503
DOI: 10.1016/s1130-1406(08)70026-3 -
European Journal of Medical Research Apr 2011Working by a distinct cell wall-specific mechanism of action, the echinocandin class of antifungals has substantially expanded the range of available treatments for... (Review)
Review
Working by a distinct cell wall-specific mechanism of action, the echinocandin class of antifungals has substantially expanded the range of available treatments for invasive Candida infections. Anidulafungin, caspofungin and micafungin were investigated versus drugs from earlier antifungal classes in large clinical trials that demonstrated their excellent clinical and microbiological efficacy in the primary treatment of invasive candidiasis. Therefore, and supported by a number of favourable pharmacological characteristics, the echinocandins rapidly became established in guidelines and clinical practice as primary treatment options for moderately to severely ill patients with invasive candidiasis. This article reviews the relevant clinical evidence that forms the basis for the use of echinocandins in the management of invasive candidiasis, and discusses their current role in the context of recent guideline recommendations and treatment optimization strategies.
Topics: Anidulafungin; Antifungal Agents; Candidiasis, Invasive; Caspofungin; Clinical Trials as Topic; Drug Interactions; Echinocandins; Guidelines as Topic; Humans; Lipopeptides; Micafungin
PubMed: 21486731
DOI: 10.1186/2047-783x-16-4-167 -
Archivos Argentinos de Pediatria Aug 2017The experience using anidulafungin for the treatment of invasive fungal infections in pediatrics is limited. In this article, we describe our experience in 55 children....
The experience using anidulafungin for the treatment of invasive fungal infections in pediatrics is limited. In this article, we describe our experience in 55 children. Anidulafungin was administered intravenously at a loading dose of 3 mg/kg once daily, followed by 1.5 mg/kg every 24 hours over a mean period of 14 days (range: 7-22 days). Patients' median age was 114 months old (interquartile range: 32-168 months old). All patients had underlying diseases. Among patients with bone marrow transplant, the difference in white blood cell count, transaminase levels, and renal function at baseline and at the end of anidulafungin administration was not significant. No adverse events were reported and no patient died from an anidulafungin-related cause. Anidulafungin may be considered an alternative for the prophylaxis or treatment of invasive fungal infections in pediatrics but methodologically robust studies are needed to confirm this.
Topics: Adolescent; Anidulafungin; Antifungal Agents; Argentina; Child; Child, Preschool; Echinocandins; Humans; Mycoses; Prospective Studies; Tertiary Care Centers; Tertiary Healthcare
PubMed: 28741344
DOI: 10.5546/aap.2017.eng.374 -
International Journal of Infectious... Sep 2019To describe the pharmacokinetic (PK) profile of anidulafungin and to evaluate its concentration in the peritoneal fluid (PF) of patients suspected of suffering from... (Observational Study)
Observational Study
OBJECTIVE
To describe the pharmacokinetic (PK) profile of anidulafungin and to evaluate its concentration in the peritoneal fluid (PF) of patients suspected of suffering from peritoneal infection undergoing abdominal surgery, in order to ensure that therapeutic levels are achieved within the peritoneal cavity.
METHODS
A descriptive, open, prospective, observational, multicentre and non-interventional study was performed. Anidulafungin was used at conventional doses. Blood and PF samples were obtained on day 2 of treatment or on any of the following days.
RESULTS
A total of 31 patients in a serious clinical condition, as demonstrated by high mean clinical severity scale scores (APACHE II and SOFA scores), were included in the study. The mean area under the curve (AUC) in PF was 30% (31±19%) of that determined in the plasma and the maximum concentration (Cmax) reached in PF (mg/l) was close to 1 (0.9±0.5). No adverse effects were observed in any of the 31 patients.
CONCLUSIONS
Anidulafungin at conventional doses reaches PF concentrations that exceed the minimum inhibitory concentration of the usual Candida spp, which explains the proven efficacy of this echinocandin in the treatment of Candida peritonitis in critically ill patients.
Topics: APACHE; Aged; Aged, 80 and over; Anidulafungin; Antifungal Agents; Area Under Curve; Ascitic Fluid; Candida; Candidiasis; Critical Illness; Echinocandins; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Peritonitis; Prospective Studies
PubMed: 31330325
DOI: 10.1016/j.ijid.2019.07.008 -
Journal of Drugs in Dermatology : JDD Dec 2007This column reviews 3 new systemic antifungal agents (posaconazole, micafungin, and anidulafungin) from the standpoint of dermatology. Posaconazole, approved to treat... (Review)
Review
This column reviews 3 new systemic antifungal agents (posaconazole, micafungin, and anidulafungin) from the standpoint of dermatology. Posaconazole, approved to treat invasive Aspergillus and Candida infections, is available in an oral suspension and resembles fluconazole, but seems to have a broader spectrum of activity. Posaconazole is effective against yeasts and molds and could be effective in treating rare fungal infections involving Zygomycetes, Mucor necrotizing fasciitis, rhinocerebral mucormycosis, some Fusarium species, Penicillium, Histoplasma, Blastomyces, Coccidioides, Paracoccidioides, and sporotrichosis, chromoblastomycosis, mycetoma, and phaeohyphomycosis, including Scedosporium apiospermum and Exophiala, Alternaria, and Bipolaris species. Posaconazole may abate onychomycosis and dermatophytes, but clinical trial data is lacking. Micafungin and anidulafungin are echinocandins like caspofungin and are useful salvage therapy for invasive aspergillosis and candidiasis. The exciting new agents have extended the armamentarium against antifungal pathogens, but have yet to find their place in the dermatologic practice.
Topics: Administration, Oral; Anidulafungin; Antifungal Agents; Dermatomycoses; Echinocandins; Humans; Infusions, Intravenous; Lipopeptides; Lipoproteins; Micafungin; Triazoles
PubMed: 18189069
DOI: No ID Found -
BMC Medicine Oct 2022The severe fever with thrombocytopenia syndrome disease (SFTS), caused by the novel tick-borne SFTS virus (SFTSV), was listed among the top 10 priority infectious...
BACKGROUND
The severe fever with thrombocytopenia syndrome disease (SFTS), caused by the novel tick-borne SFTS virus (SFTSV), was listed among the top 10 priority infectious disease by World Health Organization due to the high fatality rate of 5-30% and the lack of effective antiviral drugs and vaccines and therefore raised the urgent need to develop effective anti-SFTSV drugs to improve disease treatment.
METHODS
The antiviral drugs to inhibit SFTSV infection were identified by screening the library containing 1340 FDA-approved drugs using the SFTSV infection assays in vitro. The inhibitory effect on virus entry and the process of clathrin-mediated endocytosis under different drug doses was evaluated based on infection assays by qRT-PCR to determine intracellular viral copies, by Western blot to characterize viral protein expression in cells, and by immunofluorescence assays (IFAs) to determine virus infection efficiencies. The therapeutic effect was investigated in type I interferon receptor defective A129 mice in vivo with SFTSV infection, from which lesions and infection in tissues caused by SFTSV infection were assessed by H&E staining and immunohistochemical analysis.
RESULTS
Six drugs were identified as exerting inhibitory effects against SFTSV infection, of which anidulafungin, an antifungal drug of the echinocandin family, has a strong inhibitory effect on SFTSV entry. It suppresses SFTSV internalization by impairing the late endosome maturation and decreasing virus fusion with the membrane. SFTSV-infected A129 mice had relieving symptoms, reduced tissue lesions, and improved disease outcomes following anidulafungin treatment. Moreover, anidulafungin exerts an antiviral effect in inhibiting the entry of other viruses including SARS-CoV-2, SFTSV-related Guertu virus and Heartland virus, Crimean-Congo hemorrhagic fever virus, Zika virus, and Herpes simplex virus 1.
CONCLUSIONS
The results demonstrated that the antifungal drug, anidulafungin, could effectively inhibit virus infection by interfering with virus entry, suggesting it may be utilized for the clinical treatment of infectious viral diseases, in addition to its FDA-approved use as an antifungal. The findings also suggested to further evaluate the anti-viral effects of echinocandins and their clinical importance for patients with infection of viruses, which may promote therapeutic strategies as well as treatments and improve outcomes pertaining to various viral and fungal diseases.
Topics: Animals; Mice; Anidulafungin; Antifungal Agents; Antiviral Agents; Bunyaviridae Infections; Clathrin; Receptor, Interferon alpha-beta; SARS-CoV-2; Viral Proteins; Virus Diseases
PubMed: 36266654
DOI: 10.1186/s12916-022-02558-z -
The Journal of Antimicrobial... Jun 2014Anidulafungin is indicated as a first-line treatment for invasive candidiasis in critically ill patients. In the intensive care unit, sepsis is the main cause of acute...
BACKGROUND
Anidulafungin is indicated as a first-line treatment for invasive candidiasis in critically ill patients. In the intensive care unit, sepsis is the main cause of acute renal failure, and treatment with continuous renal replacement therapy (CRRT) has increased in recent years. Antimicrobial pharmacokinetics is affected by CRRT, but few studies have addressed the optimal dosage for anidulafungin during CRRT.
PATIENTS AND METHODS
We included 12 critically ill patients who received continuous venovenous haemodiafiltration to treat acute renal failure. Anidulafungin was infused on 3 consecutive days, starting with a loading dose (200 mg) on Day 1, and doses of 100 mg on Days 2 and 3. Blood and ultradiafiltrate samples were collected on Day 3 (during steady-state) before, and at regular intervals after, the infusion had started. Anidulafungin concentrations were determined with HPLC.
RESULTS
On Day 3, peak plasma concentrations with the 100 mg dose were 6.2 ± 1.7 mg/L and 7.1 ± 1.9 mg/L in the arterial and venous samples, respectively. The mean, pre-filter trough concentration was 3.0 ± 0.6 mg/L. The mean AUC0-24 values for plasma anidulafungin were 93.9 ± 19.4 and 104.1 ± 20.3mg·h/L in the arterial and venous samples, respectively. There was no adsorption to synthetic surfaces, and the anidulafungin concentration in the ultradiafiltrate was below the limit of detection.
CONCLUSION
The influence of CRRT on anidulafungin elimination appeared to be negligible. Therefore, we recommend no adjustments to the anidulafungin dose for patients receiving CRRT.
Topics: Anidulafungin; Antifungal Agents; Candida; Candidiasis, Invasive; Critical Illness; Echinocandins; Hemodiafiltration; Humans; Intensive Care Units
PubMed: 24468868
DOI: 10.1093/jac/dkt542 -
Revista Iberoamericana de Micologia Jun 2008We have reviewed the existing data on the efficacy of anidulafungin, which is the most recent echinocandin in the experimental treatment of fungal infections. The scarce... (Review)
Review
We have reviewed the existing data on the efficacy of anidulafungin, which is the most recent echinocandin in the experimental treatment of fungal infections. The scarce published data practically only refers to disseminated and pulmonary aspergillosis and to disseminated candidiasis. Anidulafungin shows fungistatic activity against Aspergillus fumigatus, and fungicidal activity against Candida albicans and Candida glabrata.
Topics: Anidulafungin; Animals; Antifungal Agents; Aspergillosis; Candidiasis; Disease Models, Animal; Echinocandins; Lung Diseases, Fungal
PubMed: 18473506
DOI: 10.1016/s1130-1406(08)70029-9 -
British Journal of Clinical Pharmacology Mar 2021The population pharmacokinetics (PK) of anidulafungin in critically ill patients hospitalized in intensive care units (ICUs) was explored with the intention of...
AIMS
The population pharmacokinetics (PK) of anidulafungin in critically ill patients hospitalized in intensive care units (ICUs) was explored with the intention of evaluating and optimizing dosing regimens.
METHODS
A PK study was conducted in a cohort of 13 patients treated with anidulafungin using intensive sampling during multiple periods per patient and the high-performance liquid chromatography method for drug quantification. A population PK model was developed to describe the concentration-time course of anidulafungin and the inter-individual (IIV) and interoccasion variability (IOV) of the PK parameters. Model-based PK simulations have been performed to estimate the probability of target attainment (PTA), given the pharmacokinetic/pharmacodynamic target of free 24-hour area under the free drug concentration-time curve over minimum inhibitory concentration for several dosing regimens.
RESULTS
A two-compartment PK model, with first-order elimination, best described the data with population clearance (CL) and central/peripheral volume of distribution (V1/V2) of 0.778 L/h and 10.2/21.1 L, respectively, and a mean ± s.d. AUC of 119.97 ± 46.23 mg·h/L. Pronounced IIV and IOV variability was found for CL (38% and 31%) and V1 (47% and 30%), respectively. Sequential Organ Failure Assessment (SOFA) and Body Mass Index (BMI) were found to be covariates on CL and V1, respectively. Low PTA values were calculated for borderline Clinical & Laboratory Standards Institute (CLSI)-susceptible Candida strains.
CONCLUSIONS
Although anidulafungin exposure was found comparable to that in healthy volunteers, elevated interindividual and significant interoccasion variability was found in critically ill ICU patients, which resulted in reduced PTA values in these patients.
Topics: Anidulafungin; Anti-Bacterial Agents; Cohort Studies; Critical Illness; Humans; Intensive Care Units; Microbial Sensitivity Tests
PubMed: 32633039
DOI: 10.1111/bcp.14457 -
Revista Iberoamericana de Micologia Jun 2008Anidulafungin is a new echinocandin recently approved for the treatment of esophageal candidiasis, candidemia and other forms of invasive candidiasis, such as... (Review)
Review
Anidulafungin is a new echinocandin recently approved for the treatment of esophageal candidiasis, candidemia and other forms of invasive candidiasis, such as peritonitis and intra-abdominal abscesses in non-neutropenic patients. It is fungicidal against Candida spp. and fungistatic against Aspergillus spp. It is active against Pneumocystis jirovecii. In contrast, anidulafungin does not have activity against Cryptococcus neoformans, Zygomycetes or molds, other than Aspergillus spp. The drug is well tolerated, even in patients with renal or hepatic impairment. In contrast to other echinocandins, it does not significantly interfere with the cytochrome P450 pathway and has a low drug-drug interaction profile, including calcineurinic agents and other drugs used in transplant recipients. So far, anidulafungin appears to have an excellent safety profile with few adverse events and it promises a special consideration in the management of fungal infections happening in transplant recipients.
Topics: Anidulafungin; Antifungal Agents; Echinocandins; Humans; Mycoses; Organ Transplantation; Postoperative Complications
PubMed: 18473508
DOI: 10.1016/s1130-1406(08)70031-7