Abstract
Invasive fungal infections are increasing in prevalence because of modern support for immunocompromised patients allowing longer survivial times. The risk of fungal infection has also increased because of the use of broad spectrum of antibiotics in this patient population, and the intensity and duration of immunosuppression. The list of antifungal options has expanded with renewed interest in these infections with high morbidity and mortality. Amphotericin B deoxycholate has been and continues to be the mainstay of antifungal agents. Lipid formulations of amphotericin that improve the serum and the tissue level of amphotericin B while decreasing toxicity are being increasingly used. Imidazoles, including fluconazole and itraconazole, have reduced toxicities in comparison with amphotericin B deoxycholate, but their spectrum activity is limited. Echinocandins, including caspofungin and new investigational agents with unique mechanisms of action, offer great promise as antifungal agents either alone or in a combination agent with amphotericin B. Antifungal strategies and antifungal resistance in relationship to clinical outcomes are also discussed. Copyright © 2001 by W.B. Saunders Company
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