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Updated: Jul 5, 2026

Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds
08:54

Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds

Published on: February 14, 2018

Antifungal agents--clinical pharmacokinetics and drug interactions

Hans-Peter Lipp1

  • 1University Clinic of Tuebingen, Roentgenweg, Tübingen, Germany. apotheke@med.uni-tuebingen.de

Mycoses
|May 28, 2008
PubMed

Insights

Therapeutic drug monitoring is crucial for azole antifungals due to variable levels and drug interactions. Echinocandins offer a safer alternative with fewer side effects compared to amphotericin B.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Achieving therapeutic drug levels is essential for effective antifungal treatment of mycoses.
  • Significant interindividual variability in drug concentrations necessitates careful management.
  • Triazole antifungals (itraconazole, voriconazole, posaconazole) present challenges due to drug interactions and variable levels.

Purpose of the Study:

  • To highlight the importance of Therapeutic Drug Monitoring (TDM) for azole antifungal agents.
  • To compare the safety and management profiles of different antifungal classes.

Main Methods:

  • Review of pharmacokinetic and pharmacodynamic principles of antifungal agents.
  • Analysis of clinical data regarding drug interactions and adverse effects.
  • Comparison of triazoles, echinocandins, and amphotericin B formulations.

Main Results:

  • Therapeutic Drug Monitoring is critical for itraconazole, voriconazole, and posaconazole due to interindividual variability.
  • Triazole therapy requires vigilance for a wide range of potential drug interactions.
  • Echinocandins demonstrate a more favorable safety profile with no significant nephrotoxic effects, unlike amphotericin B.

Conclusions:

  • Therapeutic Drug Monitoring is mandatory for optimizing antifungal therapy with azoles.
  • Echinocandins represent a safer alternative class of antifungals compared to amphotericin B and lipid formulations.
  • Careful consideration of drug interactions is vital during triazole antifungal treatment.

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