From the Guidelines

Rhodotorula is typically susceptible to micafungin, an echinocandin antifungal medication.

The recommended dose of micafungin for treating Rhodotorula infections is 100 mg intravenously once daily 1.
The duration of treatment depends on the severity of the infection, the patient's immune status, and clinical response, but it is usually continued for at least 2 weeks after resolution of symptoms and negative fungal cultures 1.
However, due to the potential for resistance and limited clinical data, treatment should be individualized and guided by antifungal susceptibility testing and clinical expertise.
According to the EUCAST guidelines, breakpoints for micafungin have not been established yet for Rhodotorula, but it is generally considered effective against this fungus 1.
It is essential to note that antifungal susceptibility testing should be considered in patients who have had prior treatment with an echinocandin and among those who have infection with C. glabrata or C. parapsilosis 1.
Some studies suggest that micafungin is effective against Rhodotorula, but the evidence is limited, and more research is needed to confirm its efficacy 1.
In clinical practice, micafungin is often used as an alternative to other antifungal medications, such as fluconazole or amphotericin B, especially in patients who are critically ill or have severe infections 1.

From the Research

The susceptibility of Rhodotorula to micafungin is not well-established, as most studies focus on its efficacy against Candida species 2.
However, one study suggests that echinocandins, including micafungin, do not possess in vitro activity against important basidiomycetes, including Rhodotorula 3.
Another study found that 100% of Rhodotorula strains were resistant to caspofungin, which is another echinocandin, suggesting that micafungin may also be ineffective against Rhodotorula 4.
The antifungal susceptibility profile of Rhodotorula species reinforces amphotericin B as the antifungal drug of choice for the treatment of Rhodotorula infections, rather than micafungin or other echinocandins 5, 4.

Rhodotorula species have been found to be susceptible to amphotericin B, with low MICs reported in several studies 5, 6, 4.
In contrast, Rhodotorula species have been found to be resistant to fluconazole, itraconazole, and voriconazole, with high MICs reported in several studies 5, 6, 4.
The efficacy of micafungin against Rhodotorula species is unclear, but it is likely to be ineffective based on its mechanism of action and the results of studies on other echinocandins 2, 3, 4.