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Peptide

Anidulafungin

Anidulafungin is a cyclic lipopeptide echinocandin antifungal for invasive candidiasis and candidemia. FDA-approved 2006. A-GRADE evidence: Phase 3 trial showed 76% success vs 60% fluconazole (P=0.01). Potent activity against Candida albicans, C. glabrata, C. tropicalis, C. krusei (MIC90 0.06-0.12 μg/ml). Crucially, 99% of fluconazole-resistant isolates remain susceptible. No hepatic or renal dose adjustment needed due to non-CYP450 metabolism - advantageous in critically ill patients. PRESCRIPTION ONLY - IV administration.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
6
Graded outcomes
3210

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Candidemia and Invasive Candidiasis

Candidemia and Invasive Candidiasis: outcomes studied for Anidulafungin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Activity vs Fluconazole-Resistant Candida

In vitro: 99% of 315 fluconazole-resistant Candida isolates susceptible to anidulafungin (MIC <=1 μg/ml). Important option for azole-resistant infections.

Improves (the measure goes up)Large effect16 studies

Studies that measured activity vs fluconazole-resistant candida

and 6 more in the citations list

Treatment Success (vs Fluconazole)

Phase 3 RCT: 76% anidulafungin vs 60% fluconazole achieved treatment success (95% CI 4-27%, P=0.01). Superior efficacy in invasive candidiasis and candidemia. FDA approval 2006.

Improves (the measure goes up)Moderate effect15 studies

Studies that measured treatment success (vs fluconazole)

and 5 more in the citations list

Dose-Ranging Efficacy

Phase 2 study (n=123): Success rates 84%, 90%, 89% at 50, 75, 100 mg respectively. High efficacy across dose range. 100 mg daily selected for Phase 3.

Improves (the measure goes up)Large effect14 studies

Studies that measured dose-ranging efficacy

and 4 more in the citations list

Safety in Organ Impairment

No dose adjustment needed in hepatic or renal impairment. Non-CYP450 metabolism minimizes drug interactions. Well tolerated with low discontinuation rates.

Improves (the measure goes up)Moderate effect12 studies

Studies that measured safety in organ impairment

and 2 more in the citations list

General

General: outcomes studied for Anidulafungin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

11 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect10 studies

Studies that measured antimicrobial activity

Safety/Tolerability

3 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect3 studies

Studies that measured safety/tolerability

Key findings

  • Activity vs Fluconazole-Resistant CandidaCandidemia and Invasive CandidiasisImproves (the measure goes up)
  • Treatment Success (vs Fluconazole)Candidemia and Invasive CandidiasisImproves (the measure goes up)
  • Dose-Ranging EfficacyCandidemia and Invasive CandidiasisImproves (the measure goes up)

Studies cited

26 studies from PubMed

  1. Echinocandins Pharmacokinetics: A Comprehensive Review of Micafungin, Caspofungin, Anidulafungin, and Rezafungin Population Pharmacokinetic Models and Dose Optimization in Special Populations.Clinical pharmacokinetics, 2025 · PMID 39707078
  2. Invasive Candidiasis in Patients with Solid Tumors Treated with Anidulafungin: A Post Hoc Analysis of Efficacy and Safety of Six Pooled Studies.Clinical drug investigation, 2021 · PMID 33891293
  3. Anidulafungin liposome nanoparticles exhibit antifungal activity against planktonic and biofilm Candida albicans.Journal of biomedical materials research. Part A, 2020 · PMID 32363762
  4. Anidulafungin Susceptibility Testing of Candida glabrata Isolates from Blood Cultures by the MALDI Biotyper Antibiotic (Antifungal) Susceptibility Test Rapid Assay.Antimicrobial agents and chemotherapy, 2019 · PMID 31285227
  5. Candida glabrata prosthetic joint infection, successfully treated with anidulafungin: A case report and review of the literature.Mycoses, 2018 · PMID 29272049
  6. Combination antifungal therapy for invasive aspergillosis: a randomized trial.Annals of internal medicine, 2015 · PMID 25599346
  7. Anidulafungin: advantage for the newcomer?Crit Care, 2014 · PMID 24422646
  8. Anidulafungin for the treatment of invasive candidiasisClin Microbiol Infect, 2012 · PMID 21251147
  9. Anidulafungin: an evidence-based review of its use in invasive fungal infectionsDrugs, 2011 · PMID 20862218
  10. Pharmacology and metabolism of anidulafungin, caspofungin and micafungin in the treatment of invasive candidosis: review of the literature.European journal of medical research, 2011 · PMID 21486730
  11. Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin:review of the literature.European journal of medical research, 2011 · PMID 21486731
  12. Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs: review of the literature.European journal of medical research, 2011 · PMID 21486732
  13. Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs--review of the literatureEur J Med Res, 2010 · PMID 22403130
  14. Pharmacokinetics, antifungal activity and clinical efficacy of anidulafungin in the treatment of fungal infections.Expert opinion on drug metabolism & toxicology, 2010 · PMID 20822479
  15. Pharmacology and antifungal properties of anidulafungin, a new echinocandin.Pharmacotherapy, 2009 · PMID 19113794
  16. Pharmacological properties of antifungal drugs with a focus on anidulafungin.Drugs, 2009 · PMID 19877739
  17. Anidulafungin, a new echinocandin: effectiveness and tolerability.Drugs, 2009 · PMID 19877741
  18. [In vitro antifungal activity of anidulafungin].Revista iberoamericana de micologia, 2008 · PMID 18473502
  19. [Anidulafungin: a new therapeutic approach in antifungal therapy. Pharmacology of anidulafungin].Revista iberoamericana de micologia, 2008 · PMID 18473503
  20. Anidulafungin versus fluconazole for invasive candidiasisN Engl J Med, 2007 · PMID 17576612
  21. A review of the new antifungals: posaconazole, micafungin, and anidulafungin.Journal of drugs in dermatology : JDD, 2007 · PMID 18189069
  22. The safety of anidulafungin.Expert opinion on drug safety, 2006 · PMID 17044802
  23. In vitro activities of anidulafungin against more than 2,500 clinical isolates of Candida spp., including 315 isolates resistant to fluconazoleJ Clin Microbiol, 2005 · PMID 16272464
  24. Phase 2, randomized, dose-ranging study evaluating the safety and efficacy of anidulafungin in invasive candidiasis and candidemiaAntimicrob Agents Chemother, 2004 · PMID 15155194
  25. Anidulafungin: an echinocandin antifungalDrugs, 2004 · PMID 15330749
  26. Anidulafungin: review of a new echinocandin antifungal agent.Expert review of anti-infective therapy, 2004 · PMID 15482216