Antifungals

Each year, fungi are responsible for millions of superficial and systemic infections that all require effective antifungal therapy. After more than six decades of development, existing antifungal agents represent relatively few targets and chemical classes, which include agents that alter membrane function (azole and polyene), cell wall structure (echinocandin) and DNA and protein synthesis (pyrimidine analog). Overall, these agents display a range of chemical spectrum, pharmacokinetics and pharmacodynamics, toxicity and bioavailability. A new generation of agents is needed to overcome some chemical limitations and meet the challenges posed by expanding prophylaxis and empiric therapy along with selection of drug resistant strains. The challenging history of antifungal development serves as a foundation for new discovery.