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An echinocandin is an antifungal medicine that blocks production of an important component of the fungal cell wall. The class includes caspofungin, micafungin, and anidulafungin. These medicines are administered through a vein because they are not absorbed adequately by mouth. Their strongest clinical activity is against many Candida species, with additional activity against Aspergillus species.
read more about echinocandin ...Echinocandins are commonly used as initial treatment for invasive candidiasis, including many Candida bloodstream infections. Depending on the drug, they can also treat esophageal candidiasis and selected other invasive Candida infections. They have a role in salvage or combination treatment for certain Aspergillus infections but are not generally used alone as primary treatment for invasive aspergillosis. Species identification, infection site, prior antifungal exposure, and susceptibility results guide treatment.
Echinocandins inhibit the enzyme complex responsible for producing beta-1,3-D-glucan. This glucan is a major structural component of many fungal cell walls and is absent from human cells. Reduced glucan synthesis weakens the fungal cell wall and can cause susceptible Candida cells to die. Their activity against Aspergillus commonly damages growing hyphal tips rather than completely killing every fungal structure.
Echinocandins are given as intravenous infusions in hospitals, clinics, or other supervised settings. Dosing can include a loading dose followed by daily maintenance treatment, depending on the drug. Kidney dose adjustment is generally not required, but liver function and product-specific interactions can affect treatment decisions. Duration depends on the infection site, blood-culture clearance, immune status, source control, and clinical response.
Possible effects include fever, headache, nausea, infusion reactions, vein irritation, and elevated liver enzymes. Histamine-related reactions such as flushing, rash, itching, or breathing symptoms can occur, particularly during infusion. Resistance can develop through mutations affecting the glucan-synthase target, and resistant Candida infections have been reported. Persistent or recurrent infection can require susceptibility testing and a different antifungal strategy.
Yes. They are commonly recommended as initial treatment for invasive candidiasis in many adults and older infants or children. The final choice depends on the patient and Candida species.
No currently established echinocandin in routine clinical use is adequately absorbed as a standard oral tablet. Caspofungin, micafungin, and anidulafungin are administered intravenously.
No. Their activity is strongest against many Candida species and includes selected activity against Aspergillus. They have little or no useful activity against several other fungi.
Yes. Resistance can result from mutations in genes encoding parts of the glucan-synthase target. Prior exposure and certain Candida species can increase concern for resistance.
Caspofungin. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK545140/. Date Accessed August 6, 2026.
Clinical Practice Guideline for the Management of Candidiasis: 2016 Update. Infectious Diseases Society of America. https://www.idsociety.org/practice-guideline/candidiasis/. Date Accessed August 6, 2026.
Caspofungin Acetate for Injection: Prescribing Information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e76d8d83-3691-451c-a32c-d91448c54d16. Date Accessed August 6, 2026.
Micafungin for Injection: Prescribing Information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=230fcff4-ad4b-ea25-e063-6394a90a1fab. Date Accessed August 6, 2026.
ERAXIS (Anidulafungin) for Injection: Prescribing Information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a88d9010-55fb-4a02-baff-042cd27688ea. Date Accessed August 6, 2026.