Date of Award

4-24-2020

Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

Matthew Grant, MD

Abstract

Candida endocarditis is a life-threatening, opportunistic fungal infection of the endocardium. The mortality rate of Candida endocarditis is approximately 50% and has been increasing in incidence over recent years. Historically, amphotericin B and flucytosine has been considered the standard of treatment for candida endocarditis, but is limited by safety concerns of amphotericin B, primarily nephrotoxicity and hepatotoxicity. Echinocandins, such as micafungin, have demonstrated similar efficacy in other forms of invasive candidiasis with better safety profiles, but there have been no large-scale or direct comparison trials. In this review, we summarize existing data between micafungin, an echinocandin, vs. amphotericin B and flucytosine in the setting of candida endocarditis. The information extrapolated will determine if micafungin is an appropriate comparator to amphotericin B and flucytosine for the primary treatment of candida endocarditis.

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