Current Developments in Anti-Fungal Agents

Invasive mycoses are important causes of morbidity and mortality among neutropenic and other immunocompromised patients. Candidiasis and aspergillosis are the most frequent mycoses but many other opportunistic fungal infections are emerging. The lack of appropriate diagnostic tools for an early diagnosis often implies that many patients receive empirical antifungal therapy or that therapy is started when the disease is in an advanced stage with only a remote possibility for cure. Moreover, there is a relative shortage of antifungal agents for treating these life-threatening mycoses. Nowadays, a formidable technical challenge is faced by the pharmaceutical industry in the discovery of new antifungal targets and the development of effective antifungal drugs. The number of new antifungal agents at different stages of the development pipeline is high in a clear contrast to the fact that during more than four decades, amphotericin B has been nearly the unique available therapy for invasive mycoses. This review will summarise the advances in the field of new antifungal agents, including those agents in the development process, with particular emphasis on antifungal agents currently used in the therapy of superficial and invasive fungal infections, and the increasing recognition of the importance of fungal biofilms in the outcome of treatment.