Kale-Pradhan PB, Morgan G, Wilhelm SM et al.
Pharmacotherapy 2010;30:1207–13.
This meta-analysis was designed to compare the efficacy of echinocandins with that of non-echinocandins in the treatment of candidemia or invasive candidiasis due to Candida parapsilosis. A total of five randomized, blinded, comparative trials were included in the analysis. Among cases of C parapsilosis, 102 were treated with an echinocandin and 100 with another antifungal. Successful outcomes were noted in 76.5% and 73% of patients treated with an echinocandin and non-echinocandin, respectively. The authors concluded that echinocandins were as effective as comparators for the treatment of candidemia or invasive candidiasis due to C parapsilosis.
The echinocandins exhibit excellent in vitro activity against most Candida spp. Interestingly, isolates of Candida parapsilosis have been reported to be less susceptible in vitro than other Candida spp. A considerable amount of uncertainty has emerged regarding the clinical significance of this observation.