Med Klin
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Invasive fungal infections on the intensive care unit are predominantly caused by Candida spp., most frequently manifesting as candidemia. In spite of increasing treatment options during the last 2 decades, mortality of invasive candidiasis remains high with 20-50%. With the echinocandins, a new class of antifungal drugs with activity against clinically relevant Aspergillus and Candida spp. has become available since the beginning of the new millennium. ⋯ Especially in trials utilizing amphotericin B as comparator, significantly less treatment-related adverse events were observed when using an echinocandin. Echinocandins have a low drug-drug interaction profile and are only marginally affected by liver function. Especially in ICU (intensive care unit) patients frequently showing single- or multiorgan failure and receiving a multitude of drugs with complex interactions, echinocandins have become the treatment of first choice for invasive candidiasis.