Bench-to-bedside review: Therapeutic management of invasive candidiasis in the intensive care unit

Table 7 Main differences between the three echinocandins available

Variable	Anidulafungin	Caspofungin	Micafungin
Loading dose	200 mg	70 mg	None
	100 mg for EC	No loading dose for EC
Daily dose for different indications	100 mg/day	50 mg/day	100 mg/day for candidemia
	50 mg/day for EC		150 mg/day for EC
			50 mg/day in prophylaxis
Age of patients according to FDA indication	Adults	> 3 months	Neonates
			Children
			Adults
Metabolism	Slow chemical degradation at physiologic temperature and pH	Hepatic metabolism + spontaneous chemical degradation	Hepatic metabolism + enzymatic biotransformation
Indication for Aspergillus infection	None	Yes, in patients who are refractory to or intolerant of other therapies	None
Indications in neutropenic patients	None	Empirical therapy for presumed fungal infections in febrile, neutropenic patients	Prophylaxis of Candida infections in HSCT recipients
Dose adjustment in moderate hepatic impairment	None	Dose reduced (see Table 9)	None
Dose adjustment in severe hepatic impairment	None	Unknown	Unknown

Data deriving from Food and Drug Administration (FDA) labels. EC, oesophageal candidiasis; HSCT, haematopoietic stem cell transplant.

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