%0 Journal Article
%T Equinocandinas Echinocandins
%A Jorge A Cort¨¦s L
%A July A Russi N
%J Revista chilena de infectolog¨ªa
%D 2011
%I Sociedad Chilena de Infectolog¨ªa
%X Las equinocandinas -caspofugina, micafungina y ani-dulafungina- son lipop¨¦ptidos que inhiben el crecimiento f¨²ngico al unirse a la ¦Â-(1,3) d glucano sintetasa, enzima esencial para la s¨ªntesis en la pared celular de hongos como Candida spp, y menos importante en el caso de especies de Aspergillus y Fusarium. Se revisa la historia, farmacolog¨ªa y los diferentes ensayos cl¨ªnicos que han evidenciado similar eficacia cl¨ªnica a la de anfotericina B para el manejo de infecciones mic¨®ticas como candidemia, candidiasis invasora y aspergilosis, inclusive en casos refractarios al manejo inicial. Estos medicamentos tienen menor toxicidad y en pocos casos hay necesidad de retiro del tratamiento. Dado su espectro y tolerabilidad similar, su farmacolog¨ªa permite diferenciarlas. Se dispone de informaci¨®n limitada de estudios cl¨ªnicos que las comparen entre ellas, limitando la extrapolaci¨®n de la informaci¨®n a todo el grupo. Sin embargo, presentan eficacia cl¨ªnica comprobada en pacientes con varias micosis invasoras. The echinocandins, caspofugin, micafungin, and anidulafungin, are lipopeptides that inhibit fungal growth by binding to ¦Â - (1.3) d glucan synthase. This enzyme is responsible for the formation of the peptidoglycan cell wall, and it is essential in fungi such as Candida spp, but less important in the case of Aspergillus and Fusarium species. We review the history, pharmacology and clinical trials that have showed clinical efficacy similar to amphotericin B for the management of fungal infections such as candidemia, invasive candidiasis and aspergillosis, even in cases refractory to initial treatment. These drugs have less toxicity and discontinuation is uncommonly required. Despite similar spectrum and tolerability, there are several pharmacological differences. Only a few clinical trials compare the clinical efficacy between them and their clinical application cannot be generalized. However, the echinocandins have demonstrated clinical efficacy in patients with invasive candidiasis and in others forms of systemic mycoses.
%K Equinocandinas
%K Equinocandinas/administraci¨®n y dosificaci¨®n
%K Equinocandinas/efectos adversos
%K Equinocandinas/uso terap¨¦utico
%K Equinocandinas/farmacolog¨ªa
%K Candidiasis
%K Candidiasis/terapia
%K Aspergilosis
%K Aspergilosis/terapia
%K Echinocandins
%K Echinocandins/administration and dosage
%K Echinocandins/adverse events
%K Echinocandins/pharmacology
%K Echinocandins/therapeutic use
%K Candidiasis
%K Candidiasis/therapy
%K Aspergillosis
%K Aspergillosis/therapy
%U http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182011000700004