New approaches to antifungal chemotherapy.
The antifungal agents currently available to treat invasive fungal infections are limited in both number and usefulness. Treatment with the polyene amphotericin B (AmB), and with several azoles, in particular fluconazole and itraconazole, is the mainstay of antifungal chemotherapy. However, the clinical usefulness of these drugs is hampered by drawbacks associated with their safety and/or efficacy. There are two approaches to overcome this situation. One is to discover and develop new antifungal agents or formulations with advantages over and/or complementary to existing drugs. For this purpose, the following three categories of new drugs have been the major targets of study and development: (i) lipid formulations of polyenes, (ii) azoles (including cyclodextrin-complexes), and (iii) nonazole compounds, particularly those of microbial origin (antibiotics).
Viviani
M A
MA
Istituto di Igiene e Medicina Preventiva, Università degli Studi di Milano, Italy. viviani@imiucca.csi.unimi.it
de Marie
S
S
Graybill
J R
JR
Yamaguchi
H
H
Anaissie
E
E
Caillot
D
D
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005658:Fungi / Q000187:drug effects; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D014230:Triazoles / Q000627:therapeutic use