New and emerging antifungal agents: Impact on respiratory infections

Marta Feldmesser

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Fungal pathogens are increasingly important causes of respiratory disease, yet the number of antifungal agents available for clinical use is limited. Use of amphotericin B deoxycholate is hampered by severe toxicity. Triazole agents currently available have significant drug interactions; fluconazole has a limited spectrum of activity and itraconazole was, until recently, available only in oral formulations with limited bioavailability. The development of resistance to all three agents is increasingly being recognized and some filamentous fungi are resistant to the action of all of these agents. In the past few years, new antifungal agents and new formulations of existing agents have become available. The use of liposomal amphotericin B preparations is associated with reduced, but still substantial, rates of nephrotoxicity and infusion-related reactions. An intravenous formulation of itraconazole has been introduced, and several new triazole agents have been developed, with the view of identifying agents that have enhanced potency, broader spectra of action and improved pharmacodynamic properties. One of these, voriconazole, has completed large-scale clinical trials. In addition, caspofungin, the first of a new class of agents, the echinocandins, which inhibit cell wall glucan synthesis, was approved for use in the US in 2001 as salvage therapy for invasive aspergillosis. It is hoped that the availability of these agents will have a significant impact on the morbidity and mortality of fungal respiratory infections. However, at the present time, our ability to assess their impact is limited by the problematic nature of conducting trials for antifungal therapy.

Original languageEnglish (US)
Pages (from-to)371-383
Number of pages13
JournalAmerican Journal of Respiratory Medicine
Volume2
Issue number5
StatePublished - 2003

Fingerprint

Triazoles
Itraconazole
Antifungal Agents
caspofungin
Respiratory Tract Infections
Echinocandins
Salvage Therapy
Aspergillosis
Glucans
Mycoses
Fluconazole
Drug Interactions
Cell Wall
Biological Availability
Fungi
Clinical Trials
Morbidity
Mortality
Therapeutics
deoxycholate drug combination amphotericin B

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pharmacology

Cite this

New and emerging antifungal agents : Impact on respiratory infections. / Feldmesser, Marta.

In: American Journal of Respiratory Medicine, Vol. 2, No. 5, 2003, p. 371-383.

Research output: Contribution to journalArticle

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