Current Concepts in Antifungal Pharmacology

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Current Concepts in Antifungal Pharmacology Russell E. Lewis, PharmD Mayo Clinic Proceedings Volume 86, Issue 8, Pages 805-817 (August 2011) DOI: 10.4065/mcp.2011.0247 Copyright © 2011 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Timeline of systemic antifungal drugs. Mayo Clinic Proceedings 2011 86, 805-817DOI: (10.4065/mcp.2011.0247) Copyright © 2011 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 Sites of action and mechanisms of systemic antifungal agents. FKS1, FKS2 catalytic subunits of the glucan synthase complex are the putative target binding site of echinocandins. Rho is a cell wall-regulating protein. *Isavuconazole is still in phase 3 trials. Mayo Clinic Proceedings 2011 86, 805-817DOI: (10.4065/mcp.2011.0247) Copyright © 2011 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Spectrum of action of systemic antifungal agents. Solid blocks represent species in which the antifungal agent has demonstrated microbiological and clinical efficacy. Blocks with dotted lines indicate fungal genera/species in which resistance is common. AMB = amphotericin; ANID = anidulafungin; CAS = caspofungin; 5-FC = flucytosine; FLU = fluconazole; ITRA = itraconazole; MICA = micafungin; POSA = posaconazole; VORI = voriconazole. Mayo Clinic Proceedings 2011 86, 805-817DOI: (10.4065/mcp.2011.0247) Copyright © 2011 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 4 Common toxicities of antifungal agents. CNS = central nervous system; 5-FC = flucytosine; GI = gastrointestinal; IV = intravenous; QTc = corrected QT interval. Mayo Clinic Proceedings 2011 86, 805-817DOI: (10.4065/mcp.2011.0247) Copyright © 2011 Mayo Foundation for Medical Education and Research Terms and Conditions