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Candidemia and Invasive Candidiasis

Candidemia and invasive candidiasis are infections where Candida yeast, normally harmless on skin and in the gut, reaches the bloodstream and organs. The evidence is strong for anidulafungin, which achieved treatment success in 76% of people versus 60% with fluconazole, and for rezafungin, which matched caspofungin at day 14. Rezafungin showed similarity rather than an advantage, so it looks comparable, not better.

Sources: PMID 40651396

Supplements studied
0
Medicines and peptides
4
Graded outcomes
17
No supplement studies yetWe haven’t found supplement studies for Candidemia and Invasive Candidiasis. The medicines and peptides studied for it are listed below.

Prescription medicines and peptides studied, for context

These are not supplements. Most need a prescription, and some are research compounds with no approved use.

4 medicines and peptides

Rezafungin (Rezzayo)

Rezafungin (Rezzayo): outcomes studied for Candidemia and Invasive Candidiasis
GradeOutcomeEffectSizeStudiesPeopleStudies list
Efficacy by Candida Species

Species subanalysis: Effective against C. albicans (42%), C. glabrata (26%), and C. tropicalis (20%). Consistent efficacy across major Candida species causing invasive disease.

Improves (the measure goes up)Moderate effect35 studies

Studies that measured efficacy by candida species

and 32 more on the Rezafungin (Rezzayo) page

Day-14 Global Cure

ReSTORE Phase 3 (n=187): 59% rezafungin vs 61% caspofungin achieved global cure at day 14 (EMA primary endpoint). Noninferiority demonstrated. First new echinocandin approved in >10 years.

Improves (the measure goes up)Moderate effect32 studies

Studies that measured day-14 global cure

and 29 more on the Rezafungin (Rezzayo) page

30-Day All-Cause Mortality

ReSTORE Phase 3: 24% rezafungin vs 21% caspofungin mortality at day 30 (FDA primary endpoint). Noninferior within 20% margin. Similar safety profile to other echinocandins.

NoneNo effect32 studies

Studies that measured 30-day all-cause mortality

and 29 more on the Rezafungin (Rezzayo) page

Weekly Dosing Convenience

Unique weekly dosing (vs daily for caspofungin/micafungin) enables outpatient parenteral therapy. May avoid need for central venous catheter. Improves patient convenience and reduces healthcare resource use.

Improves (the measure goes up)Moderate effect32 studies

Studies that measured weekly dosing convenience

and 29 more on the Rezafungin (Rezzayo) page

Caspofungin (Cancidas)

Caspofungin (Cancidas): outcomes studied for Candidemia and Invasive Candidiasis
GradeOutcomeEffectSizeStudiesPeopleStudies list
Invasive Candidiasis Efficacy

Approved for candidemia and invasive Candida infections including intra-abdominal abscesses, peritonitis, pleural cavity infections. Established efficacy in multiple trials. First-line option.

Improves (the measure goes up)Moderate effect31 studies

Studies that measured invasive candidiasis efficacy

and 28 more on the Caspofungin (Cancidas) page

Esophageal Candidiasis Response

Phase 2 trial (n=128): 85.1% caspofungin vs 66.7% amphotericin B achieved symptom and endoscopic improvement at 2 weeks. Superior efficacy with better tolerability.

Improves (the measure goes up)Large effect30 studies

Studies that measured esophageal candidiasis response

and 27 more on the Caspofungin (Cancidas) page

Activity vs Fluconazole-Resistant Candida

In vitro: MIC90 0.5-1 ug/ml against 157 fluconazole-resistant isolates. Retained activity against 3,959 clinical Candida isolates. Critical option for azole-resistant infections.

Improves (the measure goes up)Large effect30 studies

Studies that measured activity vs fluconazole-resistant candida

and 27 more on the Caspofungin (Cancidas) page

Safety and Tolerability

RCTs (n=263): Only 2% discontinued due to drug-related AEs. No serious clinical or laboratory adverse events. Well tolerated in 623 patients studied. Infusion reactions rare.

Improves (the measure goes up)Large effect29 studies

Studies that measured safety and tolerability

and 26 more on the Caspofungin (Cancidas) page

Micafungin (Mycamine)

  • HSCT Candida Prophylaxis: improves
  • Invasive Candidiasis/Candidemia: improves
  • Esophageal Candidiasis: improves
Micafungin (Mycamine): outcomes studied for Candidemia and Invasive Candidiasis
GradeOutcomeEffectSizeStudiesPeopleStudies list
HSCT Candida Prophylaxis

Phase 3 RCT: Micafungin superior to fluconazole for prophylaxis of invasive Candida infections in HSCT recipients. Only echinocandin FDA-approved for this indication. Significantly reduced breakthrough fungal infections.

Improves (the measure goes down)Large effect17 studies

Studies that measured hsct candida prophylaxis

and 14 more on the Micafungin (Mycamine) page

Invasive Candidiasis/Candidemia

Phase 3 trials: Excellent clinical and microbiological efficacy in primary treatment of invasive candidiasis. Comparable to caspofungin and liposomal amphotericin B. FDA-approved for candidemia.

Improves (the measure goes up)Moderate effect16 studies

Studies that measured invasive candidiasis/candidemia

and 13 more on the Micafungin (Mycamine) page

Esophageal Candidiasis

Clinical trials: Efficacy comparable to fluconazole in esophageal candidiasis treatment. FDA-approved indication. Endoscopic cure rates similar to standard therapy.

Improves (the measure goes up)Moderate effect13 studies

Studies that measured esophageal candidiasis

and 10 more on the Micafungin (Mycamine) page

Safety Profile (Pooled Analysis)

Pooled analysis of 17 trials (n=3028): Favorable clinical safety profile similar to other echinocandins. Well tolerated across treatment and prophylaxis indications. Low discontinuation rates.

Improves (the measure goes up)Large effect9 studies

Studies that measured safety profile (pooled analysis)

and 6 more on the Micafungin (Mycamine) page

Pediatric Efficacy

Approved for pediatric use. Effective for prophylaxis and treatment in children including neonates. Weight-based dosing (2-4 mg/kg). Scientific evidence supports safety and efficacy in pediatric populations.

Improves (the measure goes up)Moderate effect12 studies

Studies that measured pediatric efficacy

and 9 more on the Micafungin (Mycamine) page

Anidulafungin

  • Treatment Success (vs Fluconazole): improves
  • Activity vs Fluconazole-Resistant Candida: improves
  • Dose-Ranging Efficacy: improves
Anidulafungin: outcomes studied for Candidemia and Invasive Candidiasis
GradeOutcomeEffectSizeStudiesPeopleStudies 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 effect13 studies

Studies that measured treatment success (vs fluconazole)

and 10 more on the Anidulafungin page

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 effect13 studies

Studies that measured activity vs fluconazole-resistant candida

and 10 more on the Anidulafungin page

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 effect12 studies

Studies that measured dose-ranging efficacy

and 9 more on the Anidulafungin page

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 effect10 studies

Studies that measured safety in organ impairment

and 7 more on the Anidulafungin page

Key findings

  • Efficacy by Candida SpeciesRezafungin (Rezzayo)Improves (the measure goes up)
  • Day-14 Global CureRezafungin (Rezzayo)Improves (the measure goes up)
  • 30-Day All-Cause MortalityRezafungin (Rezzayo)

Safety notes in the studies

  • No serious clinical or laboratory adverse events.
  • May avoid need for central venous catheter.

Studies cited

100 studies from PubMed

  1. Rezafungin Versus Caspofungin for the Treatment of Candidemia and Invasive Candidiasis: Results from the Double-blind, Randomized, Phase 3 ReSTORE Trial Including the China Extension Study.Open forum infectious diseases, 2025 · PMID 41018703
  2. Early use of the novel antifungal rezafungin: a case series and literature review.The Journal of antimicrobial chemotherapy, 2025 · PMID 40366630
  3. Rezafungin: A Review in Invasive Candidiasis.Drugs, 2025 · PMID 39913021
  4. Rezafungin vs caspofungin for the treatment of invasive candidiasis: A systematic review and meta-analysis.Diagnostic microbiology and infectious disease, 2025 · PMID 40651396
  5. 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
  6. Game Changer or More of the Same? A Comparative Meta-analysis of Rezafungin and Caspofungin in Treating Candidemia and Invasive Candidiasis.Journal of community hospital internal medicine perspectives, 2024 · PMID 39399196
  7. Formulary Drug Review: Rezafungin.Hospital pharmacy, 2024 · PMID 38764996
  8. Pneumocystis jirovecii pneumonia in people living with HIV: a review.Clinical microbiology reviews, 2024 · PMID 38235979
  9. Rezafungin versus caspofungin for patients with candidaemia or invasive candidiasis in the intensive care unit: pooled analyses of the ReSTORE and STRIVE randomised trialsIntensive Care Med, 2024 · PMID 39468640
  10. Regulatory Considerations in the Approval of Rezafungin (Rezzayo) for the Treatment of Candidemia and Invasive Candidiasis in AdultsClin Infect Dis, 2024 · PMID 38502709
  11. Outcomes by Candida spp. in the ReSTORE Phase 3 trial of rezafungin versus caspofungin for candidemia and/or invasive candidiasisAntimicrob Agents Chemother, 2024 · PMID 38526046
  12. Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): a multicentre, double-blind, double-dummy, randomised phase 3 trialLancet, 2023 · PMID 36442484
  13. Erratum to: Rezafungin Versus Caspofungin in a Phase 2, Randomized, Double-Blind Study for the Treatment of Candidemia and Invasive Candidiasis: The STRIVE Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 · PMID 34165553
  14. Rezafungin Versus Caspofungin in a Phase 2, Randomized, Double-blind Study for the Treatment of Candidemia and Invasive Candidiasis: The STRIVE Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 · PMID 32955088
  15. Biological Properties and Analytical Methods for Micafungin: A Critical Review.Critical reviews in analytical chemistry, 2021 · PMID 32064916
  16. Caspofungin: a review of its characteristics, activity, and use in intensive care units.Expert review of anti-infective therapy, 2020 · PMID 32662712
  17. Micafungin-Induced Hypoglycemia in a Patient With Type 1 Diabetes: A Case Report and Review of Literature.The Journal of clinical endocrinology and metabolism, 2019 · PMID 30398618
  18. Effect of Caspofungin vs Fluconazole Prophylaxis on Invasive Fungal Disease Among Children and Young Adults With Acute Myeloid Leukemia: A Randomized Clinical Trial.JAMA, 2019 · PMID 31688884
  19. Rezafungin (CD101), a next-generation echinocandin: A systematic literature review and assessment of possible place in therapy.Journal of global antimicrobial resistance, 2018 · PMID 29486356
  20. Candida glabrata prosthetic joint infection, successfully treated with anidulafungin: A case report and review of the literature.Mycoses, 2018 · PMID 29272049
  21. Successful treatment with caspofungin of candiduria in a child with Wilms tumor; review of literature.Journal de mycologie medicale, 2017 · PMID 28188050
  22. Micafungin: prophylaxis and treatment in paediatric patientsMycoses, 2017 · PMID 28083856
  23. Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial.JAMA, 2016 · PMID 27706483
  24. Anidulafungin: advantage for the newcomer?Crit Care, 2014 · PMID 24422646
  25. Micafungin for Candida albicans pacemaker-associated endocarditis: a case report and review of the literature.Mycopathologia, 2013 · PMID 23073824
  26. Micafungin: a review of its use in the prophylaxis and treatment of invasive Candida infections.Drugs, 2012 · PMID 23083111
  27. Caspofungin for prophylaxis and treatment of fungal infections in adolescents and adults: a meta-analysis of randomized controlled trials.Die Pharmazie, 2012 · PMID 22570929
  28. Anidulafungin for the treatment of invasive candidiasisClin Microbiol Infect, 2012 · PMID 21251147
  29. Micafungin-induced thrombotic thrombocytopenic purpura: a case report and review of the literature.American journal of therapeutics, 2011 · PMID 20335786
  30. 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
  31. Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin:review of the literature.European journal of medical research, 2011 · PMID 21486731
  32. 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
  33. Accumulated safety data of micafungin in therapy and prophylaxis in fungal diseasesExpert Opin Drug Saf, 2011 · PMID 21306282
  34. Micafungin - the newest echinocandinPediatr Infect Dis J, 2011 · PMID 19856528
  35. Micafungin: a review of its use in the prophylaxis and treatment of invasive Candida infections in pediatric patients.Paediatric drugs, 2009 · PMID 19566111
  36. Micafungin: a review of its use in adults for the treatment of invasive and oesophageal candidiasis, and as prophylaxis against Candida infections.Drugs, 2008 · PMID 18840009
  37. Micafungin for the prophylaxis and treatment of Candida infectionsDrugs, 2008 · PMID 18380597
  38. Caspofungin for the treatment of fungal infections: a systematic review of randomized controlled trials.International journal of antimicrobial agents, 2007 · PMID 17207609
  39. Micafungin sodium, the second of the echinocandin class of antifungals: theory and practiceAnn Pharmacother, 2007 · PMID 17661660
  40. Micafungin: a new echinocandin antifungalClin Infect Dis, 2006 · PMID 17192162
  41. Caspofungin: a review of its use in the treatment of fungal infections.Drugs, 2005 · PMID 16162025
  42. 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
  43. Micafungin: a therapeutic review.Expert review of anti-infective therapy, 2004 · PMID 15482200
  44. Anidulafungin: an echinocandin antifungalDrugs, 2004 · PMID 15330749
  45. Phase 2, randomized, dose-ranging study evaluating the safety and efficacy of anidulafungin in invasive candidiasis and candidemiaAntimicrob Agents Chemother, 2004 · PMID 15155194
  46. Caspofungin: a review of its use in oesophageal candidiasis, invasive candidiasis and invasive aspergillosis.Drugs, 2003 · PMID 14498760
  47. In vitro activities of caspofungin compared with those of fluconazole and itraconazole against 3,959 clinical isolates of Candida spp., including 157 fluconazole-resistant isolatesAntimicrob Agents Chemother, 2003 · PMID 12604543
  48. Caspofungin: first approved agent in a new class of antifungalsClin Infect Dis, 2003 · PMID 12740003
  49. Safety and tolerability of caspofungin acetate in the treatment of fungal infectionsDrugs, 2001 · PMID 12123423
  50. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysisBMJ Evid Based Med · PMID 32817011
  51. Effects of Strength Training on Body Composition, Physical Performance, and Protein or Calcium Intake in Older People with Osteosarcopenia: A Meta-Analysis.Nutrients · PMID 40944241
  52. Effect of repeated Waon therapy on exercise tolerance and pulmonary function in patients with chronic obstructive pulmonary disease: a pilot controlled clinical trial.Int J Chron Obstruct Pulmon Dis · PMID 24363555
  53. The efficacy and safety of herbal formulas for adults with pulmonary hypertension combined with chronic obstructive pulmonary disease: a systematic review and meta-analysis involving 1,865 participants.J Thorac Dis · PMID 39444852
  54. Failure of zinc gluconate in treatment of acute upper respiratory tract infectionsAntimicrob Agents Chemother · PMID 2665639
  55. Effects of vitamin K supplementation on bone mineral density at different sites and bone metabolism in the middle-aged and elderly population.Bone Joint Res · PMID 39657786
  56. Bronchoalveolar Lavage and Plasma Cathelicidin Response to 25-Hydroxy Vitamin D Supplementation: A Pilot Study.Chronic Obstr Pulm Dis · PMID 34044475
  57. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention studyBMJ Open · PMID 23242238
  58. Vitamin D supplementation to prevent infections: a sub-study of a randomised placebo-controlled trial in older people (RECORD trial, ISRCTN 51647438)Age Ageing · PMID 17702768
  59. Vitamin D supplementation for the prevention of acute respiratory tract infection: a randomized, double-blinded trial among young Finnish menJ Infect Dis · PMID 20632889
  60. A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infectionsEpidemiol Infect · PMID 19296870
  61. Vitamin D₃ Supplementation Reduces the Symptoms of Upper Respiratory Tract Infection during Winter Training in Vitamin D-Insufficient Taekwondo Athletes: A Randomized Controlled TrialInt J Environ Res Public Health · PMID 30223447
  62. Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDARIS randomized controlled trialJAMA · PMID 23032549
  63. Vitamin D supplementation and upper respiratory tract infections in adolescent swimmers: a randomized controlled trialPediatr Exerc Sci · PMID 25050610
  64. Megadosage of ascorbic acid in an Antarctic expeditionBr J Nutr · PMID 870023
  65. Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runnersAm J Clin Nutr · PMID 8185726
  66. Vitamin C and acute illness in Navajo school childrenN Engl J Med · PMID 787788
  67. The effect of vitamin C on upper respiratory infections in adolescent swimmers: a randomized trialEur J Pediatr · PMID 20689965
  68. Randomised, double-blind, placebo-controlled trial of EPs 7630 in adults with COPDRespir Med · PMID 23478193
  69. Can the Pelargonium sidoides root extract EPs® 7630 prevent asthma attacks during viral infections of the upper respiratory tract in childrenPhytomedicine · PMID 23142309
  70. Tauroursodeoxycholic acid in the treatment of patients with amyotrophic lateral sclerosis.Eur J Neurol · PMID 25664595
  71. Efficacy and safety of three species of L. in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.Front Pharmacol · PMID 37089935
  72. Effect of Omega-3 Fatty Acids on Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Int J Chron Obstruct Pulmon Dis · PMID 34588776
  73. Efficacy and safety of nitrate supplementation on exercise tolerance in chronic obstructive pulmonary disease: A systematic review and meta-analysis.Medicine · PMID 35029233
  74. Efficacy of dietary nitrate-rich beetroot juice supplementation in patients with chronic obstructive pulmonary disease (COPD): A systematic review and meta-analysis.Clin Nutr ESPEN · PMID 33745600
  75. Evaluating the impact of short-term nitrate-rich dietary supplementation on endothelial function in COPD: A randomized crossover study.Respir Med · PMID 39053520
  76. Dietary nitrate supplementation to enhance exercise capacity in patients with COPD: Evidence from a meta-analysis of randomized controlled trials and a network pharmacological analysis.Respir Med · PMID 38158139
  77. Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial.Nat Aging · PMID 39548320
  78. The efficacy of -acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis.Ther Adv Respir Dis · PMID 36927162
  79. Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPDPulm Pharmacol Ther · PMID 15607126
  80. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trialLancet · PMID 15866309
  81. Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Ann Palliat Med · PMID 34237968
  82. Induced sputum of patients with chronic obstructive pulmonary disease (COPD) contains adhesion-promoting, therapy-sensitive factorsInflamm Res · PMID 10778915
  83. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infectionPhytomedicine · PMID 20092985
  84. No effect of glutamine ingestion on indices of oxidative metabolism in stable COPDRespir Physiol Neurobiol · PMID 21419239
  85. Efficacy and safety of single and multiple doses of pseudoephedrine in the treatment of nasal congestion associated with common coldAm J Rhinol · PMID 15794071
  86. Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trialAnn Allergy Asthma Immunol · PMID 18450126
  87. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trialArch Fam Med · PMID 9821828
  88. Demonstration of the analgesic efficacy and dose-response of acetylsalicylic acid with pseudoephedrineJ Clin Pharmacol · PMID 20350952
  89. Highly absorptive curcumin reduces serum atherosclerotic low-density lipoprotein levels in patients with mild COPDInt J Chron Obstruct Pulmon Dis · PMID 27616885
  90. No effect of creatine on respiratory distress in amyotrophic lateral sclerosisAmyotroph Lateral Scler Other Motor Neuron Disord · PMID 12061948
  91. Creatine monohydrate in ALS: effects on strength, fatigue, respiratory status and ALSFRSAmyotroph Lateral Scler · PMID 18608103
  92. A randomized sequential trial of creatine in amyotrophic lateral sclerosisAnn Neurol · PMID 12666111
  93. Effects of creatine supplementation on exercise performance and muscular strength in amyotrophic lateral sclerosis: preliminary resultsJ Neurol Sci · PMID 11677005
  94. A clinical trial of creatine in ALSNeurology · PMID 15534251
  95. Creatine for amyotrophic lateral sclerosis/motor neuron diseaseCochrane Database Syst Rev · PMID 23235621
  96. Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysisRespirology · PMID 20497386
  97. Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary diseaseAm J Respir Crit Care Med · PMID 18420964
  98. Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary diseaseThorax · PMID 15994258
  99. Creatine supplementation and physical training in patients with COPD: a double blind, placebo-controlled studyInt J Chron Obstruct Pulmon Dis · PMID 18044100
  100. Concentrated bovine colostrum protein supplementation reduces the incidence of self-reported symptoms of upper respiratory tract infection in adult malesEur J Nutr · PMID 12923655