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

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.