What is the standard caspofungin dosing for candidemia?

Caspofungin: 70 mg IV loading dose day 1, then 50 mg/day maintenance; in patients >80 kg: 70 mg/day maintenance; hepatic impairment (Child-Pugh B): reduce to 35 mg/day; no renal adjustment needed; treat candidemia for 14 days after last positive blood culture and resolution of symptoms.

When is step-down from echinocandin to fluconazole appropriate in candida?

Step-down to fluconazole once: patient clinically stable, blood cultures negative for ≥48h, susceptible Candida (not glabrata/krusei/auris), and no azole pre-exposure; typically after 5-7 days IV echinocandin; IDSA 2016 recommends fluconazole 400 mg/day step-down.

What Candida species require specific echinocandin vs triazole choice?

C. glabrata: echinocandin preferred (high azole resistance); C. krusei/C. tropicalis: echinocandin or L-AmB; C. auris: echinocandin first-line (multidrug resistant often including azoles); C. albicans/parapsilosis: fluconazole or echinocandin; C. lusitaniae: azole (amphotericin resistant).

What prophylactic echinocandin dose is used in HSCT?

Micafungin 50 mg/day IV is approved prophylaxis for neutropenic HSCT patients; superior to fluconazole in preventing invasive Aspergillus and non-albicans Candida; caspofungin 50 mg/day is an alternative; prophylaxis from transplant until neutrophil recovery >500/μL.

Does echinocandin require dose adjustment in renal failure?

No dose adjustment required for any echinocandin in renal failure (including dialysis); echinocandins are primarily hepatically metabolised; this property makes them ideal for ICU patients with AKI; no TDM required in standard dosing except obesity (caspofungin escalate to 70 mg/day in >80 kg).

Echinocandin (Caspofungin/Micafungin/Anidulafungin) Dosing Calculator

Calculates caspofungin loading dose (70 mg/70 kg), micafungin (100-150 mg/day), and anidulafungin dosing for candidemia, esophageal candidiasis, and empirical antifungal therapy in neutropenic fever.

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Frequently Asked Questions

What is the standard caspofungin dosing for candidemia?

When is step-down from echinocandin to fluconazole appropriate in candida?

What Candida species require specific echinocandin vs triazole choice?

What prophylactic echinocandin dose is used in HSCT?

Does echinocandin require dose adjustment in renal failure?