Caspofungin and Micafungin appear to be the most favorable therapeutic option for patients suffering from candidemia.

A review was carried out to investigate safety and effectiveness of antifungal agents to treat candidemia.

A systematic review with network meta-analysis, stochastic multicriteria acceptability analyses, and surface under the cumulative ranking analysis (SUCRA) was performed. Databases such as Scopus and PubMed were explored. Randomized trials determining the impact of oral antifungals (any regimen or dosage) on noxious effects, mycological cure, and discontinuation rates were incorporated.

In total, 13 trials and 3632 participants were examined. The efficacy outcomes did not considerably differ between treatments. But, 100–150 mg Micafungin, 50–150 mg Caspofungin, and 200–400 mg Rezafungin were deemed to be valuable treatments due to their greater rates of clinical and mycological responses (SUCRA total response >60%).

In comparison with other drugs, Anidulafungin displayed an inferior response. The worst medication for total response (17%) was 400 mg Fluconazole. The dropout rates for 100 mg Micafungin and 200–400 mg Rezafungin were both lower (less than 40%). When compared to 150 mg Caspofungin, conventional Amphotericin B (0.6-0.7 mg/kg) was likely to be ceased (odds ratio 0.08) and might harm hepatic function (87%).

Echinocandins are suggested as initial therapies for invasive candidiasis, with Caspofungin and Micafungin being given top attention. Rezafungin, an echinocandin that is currently being developed, is a viable solution that must be further investigated. In cases of fungal resistance or hypersensitivity, Liposomal Amphotericin B and Azoles may be utilized as second-line therapies.