Caspofungin: Pharmacodynamics, pharmacokinetics, clinical uses and treatment outcomes

Over the past decade, echinocandins have emerged as first-line antifungal agents for many Candida infections. The echinocandins have a unique mechanism of action, inhibiting the synthesis of β-1,3-d-glucan polymers, key components of the cell wall in pathogenic fungi. Caspofungin was the first echinocandin antifungal agent to become licensed for use. The objectives of this review are to summarize the existing published data on caspofungin, under the subject headings of chemistry and mechanism of action, spectrum of activity, pharmacodynamics, pharmacokinetics, clinical studies, safety, drug interactions, dosing, and an overview of the drug's current place in therapy.

Resistance of MBL gene-knockout mice to experimental systemic aspergillosis

Mannose binding lectin (MBL) is a protein of the collectin family that appears important in resistance to invasive pulmonary aspergillosis. We assessed the role of MBL in experimental systemic aspergillosis. MBL-sufficient C57BL/6 (WT) mice and B6.129S4--Mb11(tm1Kata) Mb12(tm1Kata)/J MBL A and C gene-knockout (KO) mice were infected intravenously with different inocula of Aspergillus fumigatus conidia. WT and KO mice were dose-responsively susceptible. In no instance were the KO mice more susceptible than WT. At the highest inoculum, all WT and 90% of KO mice died on day 4 (P>0.05). Reduction of the inoculum to 5.5 x 10(6) conidia was lethal, but comparison showed KO mice less susceptible to lethal infection (P<0.015). At the lowest inoculum used, deaths of KO mice were delayed, but survival was not significantly different than WT (P>0.05). These results suggest MBL may play a deleterious role in systemic aspergillosis.