Walsh & Hoyt: Caspofungin

Caspofungin is the first approved agent from a class of antifungal agents called the echinocandins. Its mechanism of action is unique in that it attacks the cell wall of the fungus, as opposed to its cell membrane. Some fungal infections, particularly candidiasis, are associated with biofilm formation on tissue surfaces. These biofilms may be recalcitrant to treatment with conventional antifungal therapies. In vitro studies suggest that the efficacy of caspofungin in candidiasis may be due, at least in part, to its activity against biofilms. In any event, it has been used successfully in patients with invasive candidiasis, esophageal candidiasis, and invasive aspergillosis. The drug is administered intravenously in a single daily dose.