Antifungal drugs
,Human fungal infections have increased dramatically
in recent years, owing mainly to advances in surgery,
cancer treatment, and critical care accompanied by
increases in the use of broad-spectrum antimicrobials
and the HIV epidemic.
Fungal infections are usually more difficult to treat
than bacterial infections, because fungal organisms grow
slowly and because fungal infections often occur in
tissues that are poorly penetrated by antimicrobial agents
(e.g., devitalized or avascular tissues). Therapy of fungal
infections usually requires prolonged treatment.
,Superficial fungal infections involve cutaneous
surfaces (skin, nails, and hair), and mucous membrane
surfaces (oropharynx and vagina).
Deepseated or disseminated fungal infections caused
by dimorphic fungi, the yeasts Cryptococcus neoformans,
and various Candida spp. respond to a limited number
of systemic agents: amphotericin B (a polyene),
flucytosine (a pyrimidine antimetabolite), the newer
azoles (ketoconazole, fluconazole, itraconazole, and
voriconazole), and caspofungin (an echinocandin).
, I. Antifungals damaging permeability
of the cell membrane
•Imidazoles: Bifonazole, Clotrimazole, Econazole,
Ketoconazole, Miconazole
•Triazoles: Fluconazole, Itraconazole, Voriconazole
•Allylamines: Terbinafine, Naftifine
•Morpholines: Amorolfine
•Thiocarbamates: Tolciclate, Tolnaftate
•Substituted pyridones: Ciclopirox
•Polyene antibiotics: Amphotericin B, Nystatin
II. Antifungals inhibiting chitin synthesis in the cell wall
•Caspofungin, Griseofulvin
III. Antifungals inhibiting synthesis of nucleic acids
•Flucytosine
,Human fungal infections have increased dramatically
in recent years, owing mainly to advances in surgery,
cancer treatment, and critical care accompanied by
increases in the use of broad-spectrum antimicrobials
and the HIV epidemic.
Fungal infections are usually more difficult to treat
than bacterial infections, because fungal organisms grow
slowly and because fungal infections often occur in
tissues that are poorly penetrated by antimicrobial agents
(e.g., devitalized or avascular tissues). Therapy of fungal
infections usually requires prolonged treatment.
,Superficial fungal infections involve cutaneous
surfaces (skin, nails, and hair), and mucous membrane
surfaces (oropharynx and vagina).
Deepseated or disseminated fungal infections caused
by dimorphic fungi, the yeasts Cryptococcus neoformans,
and various Candida spp. respond to a limited number
of systemic agents: amphotericin B (a polyene),
flucytosine (a pyrimidine antimetabolite), the newer
azoles (ketoconazole, fluconazole, itraconazole, and
voriconazole), and caspofungin (an echinocandin).
, I. Antifungals damaging permeability
of the cell membrane
•Imidazoles: Bifonazole, Clotrimazole, Econazole,
Ketoconazole, Miconazole
•Triazoles: Fluconazole, Itraconazole, Voriconazole
•Allylamines: Terbinafine, Naftifine
•Morpholines: Amorolfine
•Thiocarbamates: Tolciclate, Tolnaftate
•Substituted pyridones: Ciclopirox
•Polyene antibiotics: Amphotericin B, Nystatin
II. Antifungals inhibiting chitin synthesis in the cell wall
•Caspofungin, Griseofulvin
III. Antifungals inhibiting synthesis of nucleic acids
•Flucytosine
