Caspofungin Dosing in Acute Kidney Injury

Clinical Implications

Echinocandins, including caspofungin, are recommended as first-line therapy for invasive candidiasis, particularly in critically ill patients who often have renal dysfunction, by the Infectious Diseases Society of America 1, 2
Unlike many other antimicrobials, such as amphotericin B formulations, which are associated with nephrotoxicity and may worsen existing AKI, caspofungin can be administered at standard doses without concern for toxicity due to accumulation 1

Flucytosine requires significant dose adjustment in renal impairment as >90% is excreted unchanged in urine, according to the Clinical Infectious Diseases guidelines 1