Echinocandins: What They Are, How They Work, and When They're Used

When you have a serious fungal infection that won’t respond to regular antifungals, doctors turn to echinocandins, a class of intravenous antifungal medications that target the cell wall of dangerous fungi. Also known as caspofungin, micafungin, or anidulafungin, these drugs are often the first choice in hospitals for life-threatening infections like invasive candidiasis. Unlike older antifungals that attack the cell membrane, echinocandins stop fungi from building their outer shell—making it impossible for them to survive and spread.

These drugs are especially critical for patients with weakened immune systems—those in intensive care, undergoing chemotherapy, or with long-term IV lines. They’re the go-to for Candida infections, a type of yeast that can enter the bloodstream and cause sepsis, and sometimes used for Aspergillus, a mold that can invade lungs and spread to other organs. You won’t find them in your local pharmacy—they’re only given in hospitals because they require IV infusion and careful monitoring. Their strength comes with precision: they’re narrow-spectrum, meaning they hit fungi hard but leave most bacteria alone, reducing collateral damage to your gut flora.

What makes echinocandins stand out? They’re less likely to cause kidney damage than older antifungals like amphotericin B, and they work even when other drugs fail. But they’re not magic—they don’t work well against all fungi, like certain molds or yeast strains that have developed resistance. That’s why doctors rely on lab tests to confirm the infection type before starting treatment. If you’re on an echinocandin, expect daily blood tests to check liver function and watch for rare side effects like flushing, low blood pressure, or fever during infusion.

Below, you’ll find real-world insights from patients and providers who’ve dealt with fungal infections, drug interactions, and treatment challenges. From how echinocandins fit into broader antifungal strategies to what happens when they don’t work, these posts give you the practical details you won’t find in a textbook. Whether you’re a patient, caregiver, or healthcare worker, this collection helps you understand not just what echinocandins are—but when and why they matter.