The antifungal activity of caspofungin in combination with antifungals or non-antifungals against Candida species in vitro and in clinical therapy

Expert Rev Anti Infect Ther. 2022 Feb;20(2):161-178. doi: 10.1080/14787210.2021.1941868. Epub 2021 Jun 28.

Abstract

Introduction: Candida species have been regarded as global health threats due to their ability to cause invasive infections. It is challenging to treat Candida bloodstream infections, which are associated with high mortality levels. Monotherapy with antifungals is sometimes not effective against severe Candida infections, and combination therapy is needed in clinical practice.

Areas covered: This review was undertaken based on data from a PubMed search for English language reports published before March 2021 by using the terms 'caspofungin,' 'Candida species,' 'combination therapy,' 'antifungal effect,' and 'novel antifungal agent.'

Expert opinion: Combination therapy is an empirical strategy for treating refractory Candida infections. Caspofungin has been recommended to treat candidaemia. Caspofungin in combination therapy has some applications, while the efficacy of combination therapy in the treatment of refractory Candida infections needs more study, such as randomized controlled trials. In addition, novel compounds or drugs with potential antifungal activities have been examined, and some of them exhibit synergistic interactions with caspofungin. Thus, the antifungal activity of caspofungin in combination with antifungals or non-antifungals against Candida species in vitro and in clinical therapy is summarized.

Keywords: Combination therapy; antifungal effect; candida species; caspofungin; potential antifungal agents.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Candida
  • Candidemia* / drug therapy
  • Candidiasis* / drug therapy
  • Caspofungin / pharmacology
  • Echinocandins / pharmacology
  • Echinocandins / therapeutic use
  • Humans
  • Lipopeptides / pharmacology
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin