title: Azole antifungals: 35 years of invasive fungal infection management.
abstract: Prior to 1981, treatment options for invasive fungal infections were limited and associated with significant toxicities. The introduction of ketoconazole marked the beginning of an era of dramatic improvements over previous therapies for non-life-threatening mycosis. After nearly a decade of use, ketoconazole was quickly replaced by the triazoles fluconazole and itraconazole due to significant improvements in pharmacokinetic profile, spectrum of activity and safety. The triazoles posaconazole and voriconazole followed, and were better known for their further extended spectrum, specifically against emerging mold infections. With the exception of fluconazole, the triazoles have been plagued with significant inter- and intrapatient pharmacokinetic variability and all possess significant drug interactions. Azoles currently in development appear to combine an in vitro spectrum of activity comparable to voriconazole and posaconazole with more predictable pharmacokinetics and fewer adverse effects.
authors.affiliation: Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA.
authors.forename: David
authors.initials: D
authors.lastname: Allen
authors.forename: Dustin
authors.initials: D
authors.lastname: Wilson
authors.forename: Richard
authors.initials: R
authors.lastname: Drew
authors.forename: John
authors.initials: J
authors.lastname: Perfect
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001393:Azoles / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*
chemical_list: D000935:Antifungal Agents; D001393:Azoles
keywords: albaconazole; antifungals; azole; isavuconazole; ravuconazole