Therapy of systemic fungal infections: a pharmacologic perspective

Valerie Wiebe1, Margo Karriker

  • 1Department of Pharmacy, Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA. vjwiebe@ucdavis.edu

Insights

Systemic fungal infections are increasing, with rising drug resistance and treatment failures. This review covers current antifungal drugs, their challenges, and promising new agents for treating mycosis.

Area of Science:

  • Medical Mycology
  • Pharmacology
  • Infectious Diseases

Background:

  • Increasing incidence of severe, invasive, systemic fungal infections in human and veterinary medicine.
  • Rising reports of antifungal drug resistance and therapeutic failure.
  • Contributing factors include immune suppression, broad-spectrum antibiotic use, and suboptimal antifungal treatments.

Purpose of the Study:

  • To review the pharmacology and toxicology of current systemic antifungal agents.
  • To introduce newer antifungal agents with promising anecdotal results.
  • To address challenges in treating systemic mycosis, including drug resistance and interactions.

Main Methods:

  • Literature review of current and emerging antifungal agents.
  • Analysis of factors contributing to antifungal resistance and therapeutic failure.
  • Summary of pharmacological and toxicological profiles of systemic antifungals.

Main Results:

  • Current antifungal agents face challenges including resistance, drug/drug, and drug/food interactions.
  • Suboptimal drug use (e.g., fungistatic drugs, poor absorption) contributes to acquired resistance.
  • Emerging antifungal agents show promising results, warranting further investigation.

Conclusions:

  • Addressing the rise in systemic fungal infections requires understanding current antifungal limitations.
  • Optimizing antifungal therapy and exploring novel agents are crucial for improved patient outcomes.
  • Further research into the pharmacology and toxicology of new antifungals is needed.

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