Antifungal Agents

Jennifer M Fostel, Pharmacia Corporation, Kalamazoo, Michigan, USA

Published online: April 2001

DOI: 10.1038/npg.els.0000345

Antifungal agents are used to treat fungal infections ranging in severity from superficial to life-threatening. Current agents available to treat serious, invasive fungal infections are effective but have limitations. New classes are being developed to improve treatment options for patients with infections refractory to current therapies.

Keywords: amphotericin B; fluconazole; ketoconazole; mycoses; candidiasis

Figure 1. Griseofulvin.
Figure 2. 5-Fluorocytosine.
Figure 3. Nikkomycin Z.
Figure 4. Pradimicin.
Figure 5. Polyenes: (a) amphotericin B; (b) nystatin.
Figure 6. Imidazoles: (a) clotrimazole; (b) miconazole; (c) ketoconazole.
Figure 7. Trizoles: (a) fluconazole; (b) itraconazole.
Figure 8. Investigational azoles: (a) voriconazole; (b) ravuconazole; (c) posaconazole.
Figure 9. Allylamines: (a) naftifine; (b) terbinafine.
Figure 10. Candins: (a) caspofungin; (b) VER-002; (c) FK463.
Figure 11. Sordarin.
Figure 12. Chronology of discovery of fungal agents. ABCD, amphotericin B colloidal dispersion; ABLC, amphotericin B lipid complex; 5-FC, 5-fluorouracil; L-AmB, liposomal amphotericin B; NCCLS, National Committee for Clinical Laboratory Standards.
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 References
    Andriole VT (1998) Current and future therapy of invasive fungal infections. Current Clinical Topics in Infectious Diseases 18: 19–36.
    Bradley MC, Leidich S, Isham N, Elewski BE and Ghannoum MA (1999) Antifungal susceptibilities and genetic relatedness of serial Trichophyton rubrum isolates from patients with onychomycosis of the toenail. Mycoses 43 (supplement 2): 105–110.
    Dominguez JM, Kelly VA, Kinsman OS et al. (1998) Sordarins: a new class of antifungals with selective inhibition of the protein synthesis elongation cycle in yeasts. Antimicrobial Agents and Chemotherapy 42: 2274–2278.
    Hitchcock CA (1993) Resistance of Candida albicans to azole antifungal agents. Biochemical Society Transactions 21: 1039–1047.
    Kurtz MB, Heath IB, Marrinan J et al. (1994) Morphological effects of lipopeptides against Aspergillus fumigatuscorrelate with activities against (1,3)--d-glucan synthase. Antimicrobial Agents and Chemotherapy 38: 1480–1489.
    book "National Committee for Clinical Laboratory Standards" (1997) Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. M27-A. Villanova, PA: NCCLS.
    Rangel-Frausto MS, Wiblin T, Blumberg HM et al. and the NEMIS Study Group (1999) National Epidemiology of Mycoses Survey (NEMIS): variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units. Clinical Infectious Diseases 29: 253–258.
    Rex JH, Pfaller MA, Galgiani JN et al. for the Subcommittee on Antifungal Testing of the National Committee for Clinical Laboratory Standards (1997) Development of interpretive breakpoints for antifugal susceptibility testing: conceptual framework and analysis of in vitro–in vivocorrelation data for fluconazole, itraconazole, and Candidaisolates. Clinical Infectious Diseases 24: 235–247.
    Ryder NS (1999) Activity of terbinafine against serious fungal pathogens. Mycoses 43 (supplement 2): 115–119.
    Vanden Bossche H, Dromer F, Isham N et al. (1998) Antifungal drug resistance in pathogenic fungi. Medical Mycology 36 (supplement 1): 119–128.
    Williams KM and Kearns GL (2000) Lipid amphotericin preparations. Pediatric Infectious Disease Journal 19: 567–569.
    Wong-Beringer A, Jacobs RA and Guglielmo BJ (1998) Lipid formulations of amphotericin B: clinical efficacy and toxicities. Clinical Infectious Diseases 27: 603–618.
 Further Reading
    Arikan S and Rex JH (2000) New agents for treatment of systemic fungal infections. Emerging Drugs 5: 135–160.
    Denning DW (1997) Echinocandins and pneumocandins: a new antifungal class with a novel mode of action. Journal of Antimicrobial Chemotherapy 40: 611–614.
    Georgopapadakou NH (1998) Antifungals: mechanism of action and resistance, established and novel drugs. Current Opinion in Microbiology 1: 547–557.
    Ghannoum MA and Rice LB (1999) Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clinical Microbiology Reviews 12: 501–517.
    book "National Committee for Clinical Laboratory Standards" (1997) Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. M27-A. Villanova, PA: NCCLS.
    Rex JH, Pfaller MA, Rinaldi MG, Polak A and Galgiani JN (1993) Antifungal susceptibility testing. Clinical Microbiology Reviews 6: 367–381.
    Sheehan DJ, Hitchcock CA and Sibley CM (1999) Current and emerging azole antifungal agents. Clinical Microbiology Reviews 12: 40–79.
    Van Bambeke F, Balzi E and Tulkens PM (2000) Antibiotic efflux pumps. Biochemical Pharmacology 60: 457–470.

Related Sub-Topics:

Medical Microbiology | Fungi
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Article Title: Antifungal Agents
 
How to Cite close
Fostel, Jennifer M(Apr 2001) Antifungal Agents. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0000345]