Rezafungin for Sternal Wound Infection Caused by Multidrug-Resistant Candida auris: A Case Report

2. Abstract Introduction Candida auris is an emerging multidrug-resistant fungal pathogen with high mortality in critically ill or immunocompromised patients. Limited treatment options and infection control challenges complicate management. Rezafungin, a novel echinocandin with an extended half-life, enables once-weekly administration, facilitating outpatient therapy. Case Presentation A 58-year-old man developed a postoperative sternal wound infection due to multidrug-resistant C. auris following aortic valve replacement and coronary artery bypass grafting. After surgical debridement and inpatient caspofungin therapy, he transitioned to outpatient rezafungin (400 mg loading dose, then 200 mg weekly) combined with oral itraconazole. VAC dressing changes were coordinated with weekly infusions. After 12 weeks, clinical and microbiological resolution was achieved without adverse events. Conclusion This case demonstrates the potential of rezafungin as an effective outpatient therapy for complex C. aurisinfections. Once-weekly dosing offers clinical and logistical advantages, improving patient experience and reducing healthcare resource utilization.