Six new agents for the treatment of life-threatening fungal disease are currently undergoing clinical trials and registration. Three of them are triazole agents and three are echinocandins. Both of these antifungal classes have been known for 20 years or more, but the new agents create excitement that they may offer improvements in the therapeutic management of difficult mycoses. All three of the new triazoles, posaconazole, ravuconazole and voriconazole, show fungicidal activity against some mould isolates, notably strains of Aspergillus fumigatus, and their spectra extend, at least in vitro, to some isolates of Fusarium spp. and Zygomycetes, which were previously rarely inhibited by triazole agents. The three new echinocandins, anidulofungin, caspofungin and micafungin, all extend the antifungal spectrum of the class into mould genera, particularly Aspergillus spp., and caspofungin is now officially indicated for salvage therapy in aspergillosis in the USA because of its successful performance in clinical trials. Future antifungal discoveries would usefully involve novel fungal targets. The sordarin class, another group of old drugs inhibits fungal protein elongation; whether this activity can be translated into clinically useful agents is currently an open question.
Full conference title:
22nd International Congress of Chemotherapy (ICC)
- ICC 22nd