Fungicidal activity of anidulafungin in serum from patients does not correlate to its susceptible breakpoint against Candida spp.

A et al. A multicenter trial of the efficacy and safety of tigecycline versus imipenem/cilastatin in patients with complicated intra-abdominal infections. BMC Infect Dis 2005; 5: 88. 2 Ellis-Grosse EJ, Babinchak T, Dartois N et al. The efficacy and safety of tigecycline in the treatment of skin and skin-structure infections: results of 2 double-blind phase 3 comparison studies with vancomycin-aztreonam. 3 Tanaseanu C, Bergallo C, Teglia O et al. Integrated results of 2 phase 3 studies comparing tigecycline and levofloxacin in community-acquired pneumonia. 4 Curcio D. Tigecycline for treating bloodstream infections: a critical analysis of the available evidence. 6 Jenkins I. Linezolid-and vancomycin-resistant Enterococcus faecium endocarditis: successful treatment with tigecycline and daptomycin. 7 Schutt AC, Bohm NM. Multidrug-resistant Enterococcus faecium endocarditis treated with combination tigecycline and high-dose daptomycin. 9 Florescu I, Beuran M, Dimov R et al. Efficacy and safety of tigecycline compared with vancomycin or linezolid for treatment of serious infections with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci: a Phase 3, multicentre, double-blind, randomized study. 10 Cunha BA. Once-daily tigecycline therapy of multidrug-resistant and non-multidrug-resistant Gram-negative bacteraemias. 12 Anthony K, Fishman N, Linkin D et al. Clinical and microbiological outcomes of serious infections with multidrug-resistant Gram-negative organisms treated with tigecycline. A Phase 3, open-label, non-comparative study of tigecycline in the treatment of patients with selected serious infections due to resistant Gram-negative organisms including Enterobacter species, Acinetobacter baumannii and Klebsiella pneumoniae. Use of tigecycline for the treatment of prolonged bacteraemia due to a multiresistant VIM-1 and SHV-12 b-lactamase-producing Klebsiella pneumoniae epidemic clone. Clinical experience of serious infections caused by Enterobacteriaceae producing VIM-1 metallo-b-lactamase in a Greek university hospital. 18 Rolston K, Raad I, Hachem R et al. Tigecycline use in cancer patients with serious infections. A report on 110 cases from a single institution. Fungicidal activity of anidulafungin in serum from patients does not correlate to its susceptible breakpoint against Candida spp. Sir, Echinocandins, such as anidulafungin, are now considered a primary treatment for patients with suspected candidiasis or candidaemia. 1 Common Candida spp. are highly susceptible to these antifungal agents and .99% of isolates are inhibited by 2 mg/L, the current susceptible breakpoint. 2 In vitro time – kill studies find that echinocandins are fungicidal against Candida spp. at concentrations achieved in serum. 3 A major concern with the results from in vitro studies is the absence of testing in the presence of serum proteins. The echinocandins are highly …