Therapy of systemic fungal infections: a pharmacologic perspective.
An increase in the incidence of severe, invasive, systemic fungal infections has been noted over the last decade in human and veterinary medicine. Reports of drug resistance and therapeutic failure to currently available antifungal agents have also been on the rise. Many factors are likely to be involved in these trends, including immune suppression and the use of broad-spectrum antibiotics. The use of fungistatic drugs, suboptimal doses, compounded drugs, poorly absorbed drug formulations, and inadequate tissue penetrations of antifungals also contribute to the development of acquired resistance. Because of the unique chemical complexities of the antifungal agents, drug/drug and drug/food interactions may also play a significant role in poor therapeutic outcome. This review summarizes the pharmacology and toxicology of the antifungal agents in current use for systemic mycosis and introduces some of the newer antifungal agents that anecdotally show very promising results.
Wiebe
Valerie
V
Department of Pharmacy, Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA. vjwiebe@ucdavis.edu
Karriker
Margo
M
D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy / Q000662:veterinary*; D008826:Microbial Sensitivity Tests; D003904:Mitosporic Fungi / Q000187:drug effects*
D000935:Antifungal Agents