Antifungal Agents: Spectrum of Activity, Pharmacology, and Clinical Indications

Jeniel E Nett; David R Andes

doi:10.1016/j.idc.2015.10.012

Antifungal Agents: Spectrum of Activity, Pharmacology, and Clinical Indications

Infect Dis Clin North Am. 2016 Mar;30(1):51-83. doi: 10.1016/j.idc.2015.10.012. Epub 2015 Dec 29.

Authors

Jeniel E Nett¹, David R Andes²

Affiliations

¹ Department of Medicine, University of Wisconsin, Madison, WI 53705, USA; Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, WI 53705, USA.
² Department of Medicine, University of Wisconsin, Madison, WI 53705, USA; Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, WI 53705, USA. Electronic address: dra@medicine.wisc.edu.

PMID: 26739608
DOI: 10.1016/j.idc.2015.10.012

Abstract

The currently available antifungal therapies vary significantly in terms of spectrum of activity, pharmacologic properties, toxicity, and potential for drug-drug interactions. This article provides a history of antifungal development and discusses the characteristics of individual drugs and drug classes, including the amphotericin B formulations, the triazoles, the echinocandins, and flucytosine. For each drug, the clinically relevant pharmacokinetics are reviewed, the spectrum of activity described, and the Food and Drug Administration-approved clinical indications examined. Antifungal side-effects, therapeutic drug monitoring, and drug-drug interactions are summarized. The variations among different formulations are highlighted.

Keywords: Amphotericin B; Antifungal; Azole; Echinocandins; Indications; Pharmacokinetics; Spectrum of activity; Toxicity.

Publication types

Review

MeSH terms

Antifungal Agents / pharmacology*
Antifungal Agents / therapeutic use*
Humans
Mycoses / drug therapy*

Substances

Antifungal Agents