New facets of antifungal therapy.
Invasive fungal infections remain a major cause of morbidity and mortality in immunocompromised patients, and such infections are a substantial burden to healthcare systems around the world. However, the clinically available armamentarium for invasive fungal diseases is limited to 3 main classes (i.e., polyenes, triazoles, and echinocandins), and each has defined limitations related to spectrum of activity, development of resistance, and toxicity. Further, current antifungal therapies are hampered by limited clinical efficacy, high rates of toxicity, and significant variability in pharmacokinetic properties. New antifungal agents, new formulations, and novel combination regimens may improve the care of patients in the future by providing improved strategies to combat challenges associated with currently available antifungal agents. Likewise, therapeutic drug monitoring may be helpful, but its present use remains controversial due to the lack of available data. This article discusses new facets of antifungal therapy with a focus on new antifungal formulations and the synergistic effects between drugs used in combination therapy.
a Department of Plant Pathology and Microbiology , National Taiwan University , Taipei , Taiwan.
Ya-Lin
YL
Chang
a Department of Plant Pathology and Microbiology , National Taiwan University , Taipei , Taiwan.
Shang-Jie
SJ
Yu
b Department of Molecular Genetics and Microbiology , Duke University , Durham , NC , USA.
Joseph
J
Heitman
c Department of Pediatrics , University of Rochester Medical Center , Rochester , NY , USA.
Melanie
M
Wellington
a Department of Plant Pathology and Microbiology , National Taiwan University , Taipei , Taiwan.
Ying-Lien
YL
Chen
D000935:Antifungal Agents / Q000737:chemistry* / Q000627:therapeutic use*; D055808:Drug Discovery; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D000072742:Invasive Fungal Infections / Q000188:drug therapy* / Q000382:microbiology; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D011090:Polyenes / Q000737:chemistry / Q000627:therapeutic use; D014230:Triazoles / Q000737:chemistry / Q000627:therapeutic use
D000935:Antifungal Agents; D054714:Echinocandins; D011090:Polyenes; D014230:Triazoles
combination therapy; fungal pathogens; new antifungal formulations