Systemic antifungal drugs
John R. Graybill
Infectious Diseases Division, University of Texas Health Science Center,
San Antonio, Texas, USA
In recent years there have been major new developments in systemic antifungal
drugs. For amphotericin B there are several lipid formulations recently
developed. These clearly reduce infusion and nephrotoxicity, allowing large
doses to be administered safely. It remains less clear how much more effective
are the lipid formulations as compared to amphotericin B desoxycholate.
For the triazoles, itraconazole has been reformulated into a solution which
improves oral absorption and can also be given intravenously. The clinical
impact of this is still uncertain. Voriconazole and posaconazole are two
new broad spectrum triazoles which will compete with itraconazole for activity
in fluconazole resistant yeast and mycelial pathogens. Finally, a new class,
the echinocandins, is under Phase III study.
Three competitors are highly active against Candida and some mycelial
pathogens. Their ultimate role has not been defined. All of these developments
provide the clinician with an increasing array of choices to use in the
expanding word of systemic mycoses.
In: Kushwaha RKS, Guarro J (Eds.). Biology
of Dermatophytes and other Keratinophilic Fungi.
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Revista Iberoamericana de Micología, Bilbao, 2000.