Echinocandins for Primary Therapy of Candidemia: Time for a Paradigm Shift?

Candidemia is a common healthcare-associated bloodstream infection that is continuing to increase in incidence. Candidemia is associated with significant morbidity and mortality, which may be potentiated by delays in the initiation of early and appropriate therapy. Recently, the epidemiology of candidemia has shifted, and infections due to non-albicans Candida species as the causative pathogens have increased in frequency. Several studies have been published over the past 5 years in relation to the management of candidemia. Echinocandins have demonstrated favorable clinical responses with a low incidence of adverse effects in patients with candidemia due to both Candida albicans and non-albicans Candida species and, as such, have emerged as the preferred initial therapy.