Antifungal Agents

The currently available antifungal therapies vary significantly in terms of spectrum of activity, pharmacologic properties, toxicity, and potential for drug–drug interactions. This article provides a history of antifungal development and discusses the characteristics of individual drugs and drug classes, including the amphotericin B formulations, the triazoles, the echinocandins, and flucytosine. For each drug, the clinically relevant pharmacokinetics are reviewed, the spectrum of activity described, and the Food and Drug Administration–approved clinical indications examined. Antifungal side-effects, therapeutic drug monitoring, and drug–drug interactions are summarized. The variations among different formulations are highlighted.