Anidulafungin 100mg powder for solution for infusion vials

Imaging of infections has the potential to improve clinical outcomes, but pathogen-specific imaging strategies are currently unavailable. Given their target specificity, antimicrobials may be useful as molecular imaging ligands to target infections. Despite substantial development efforts, no antimicrobial-based ligands are approved for clinical use. This scoping review comprehensively surveys radiolabeled antimicrobials across antibacterial, antimycobacterial, antiviral, and antifungal drug classes, examining their progression through the translational pipeline. The review utilized PubMed and Google Scholar databases (1970-2025), following PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Two reviewers independently screened titles, abstracts, and full-text articles; data were extracted, and content duplicates were removed. In total, 143 preclinical and 25 clinical articles met the selection criteria. In clinical studies, most tracers showed suboptimal specificity for infections, while some proved useful for pharmacokinetic characterization. Among preclinical studies, radiolabeled plazomicin and echinocandins (caspofungin and anidulafungin) exhibited the greatest number of preferred characteristics. In conclusion, ideal antimicrobial pharmacologic properties can be counterproductive for imaging, where rapid background clearance and a high target-to-non-target ratio (T/NT) are essential. Many radioligands demonstrate good tissue penetration but suboptimal washout, limiting their diagnostic value. In vivo pharmacokinetic applications during active infections are promising, though significant challenges remain for infection imaging.

Abstract licence: CC BY

Kathryn Sabol, Tawanda GumboUniversity of Texas Southwestern Medical Center, Dallas, TX, USAAbstract: More antifungal agents have reached clinical use in the past two decades than at any other time. The echinocandins have been a welcome addition to this group, with the latest being anidulafungin. There are several lines of evidence to support anidulafungin’s role as primary therapy for the treatment of invasive candidiasis in non-neutropenic patients, and as alternative therapy to fluconazole in patients with esophageal candidiasis with azole intolerance or triazole-resistant Candida. Pharmacokinetic–pharmacodynamic studies in animals have demonstrated superior efficacy, defined as maximal microbial kill, when compared to fluconazole, regardless of the fluconazole susceptibility of the Candida species. These studies, as well as dose-effect studies in patients, also support the currently recommended dose of anidulafungin. A well designed randomized controlled trial has demonstrated anidulafungin’s efficacy in patients with invasive candidiasis. In this paper, we argue that anidulafungin may be preferable to fluconazole for the treatment of candidemia. However, as of yet, the difference between anidulafungin and the other two licensed echinocandins as first-line therapy for invasive candidiasis is unclear. On the other hand, there is insufficient evidence as of yet to support first-line use of anidulafungin in patients with neutropenia or aspergillosis.Keywords: anidulafungin, pharmacokinetics-pharmacodynamics, efficacy, candidiasis

Abstract licence: CC BY-NC 3.0