The Echinocandin Era

Segment Description: László Majoros, MD, PhD, an associate professor of Medical Microbiology, at the University of Debrecen, in Hungary, discusses how nearly all invasive fungal infections are being treated with echinocandins.

Interview transcript: (modified slightly for readability)

In the last 2,3 decades, the number of fungal infections has significantly increased, including Candida infections. It is very important that we are in the middle of the echinocandin era, meaning that for practically all invasive infections we use echinocandins. For example, caspofungin, micafungin, anidulafungin. But despite the introduction of this new antifungal drug class, mortality rate is still high — up to 70-75%, especially among cancer patients and among patients with severe acute necrotizing Candida infections.

What does it mean in the practice? These antifungal drugs may not be sufficient to treat severe, life-threatening infections. Why? For example, does the drug have appropriate therapeutic concentrations for the infection? In the blood? In the pleural cavity? In the abdomen?

So, it is a big problem because we are not able to cure the patient and so many of them die despite adequate antifungal treatment.