Current and Emerging Azole Antifungal Agents

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Clinical Microbiology Reviews, January 1999, p. 40-79, Vol. 12, No. 1
0893-8512/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Current and Emerging Azole Antifungal Agents

Daniel J. Sheehan,¹^,^* Christopher A. Hitchcock,² and Carol M. Sibley³

Pfizer Pharmaceuticals Group, Pfizer Inc., New York, New York¹; Department of Discovery Biology, Pfizer Central Research, Sandwich CT13 9NJ, United Kingdom²; and Medical/Scientific Communications, Inc., Bloomfield, New Jersey³

Major developments in research into the azole class of antifungal agents during the 1990s have provided expanded options forthe treatment of many opportunistic and endemic fungal infections.Fluconazole and itraconazole have proved to be safer than bothamphotericin B and ketoconazole. Despite these advances, seriousfungal infections remain difficult to treat, and resistance tothe available drugs is emerging. This review describes presentand future uses of the currently available azole antifungal agentsin the treatment of systemic and superficial fungal infectionsand provides a brief overview of the current status of in vitrosusceptibility testing and the growing problem of clinical resistanceto the azoles. Use of the currently available azoles in combinationwith other antifungal agents with different mechanisms of actionis likely to provide enhanced efficacy. Detailed information onsome of the second-generation triazoles being developed to provideextended coverage of opportunistic, endemic, and emerging fungalpathogens, as well as those in which resistance to older agentsis becoming problematic, isprovided.

^* Corresponding author. Mailing address: Pfizer Pharmaceuticals Group, Pfizer Inc., 235 East 42nd St., New York, NY 10017-5755.Phone: (212) 573-7741. Fax: (212) 573-5916. E-mail: sheehd{at}pfizer.com.

Clinical Microbiology Reviews, January 1999, p. 40-79, Vol. 12, No. 1
0893-8512/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

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Antimicrob. Agents Chemother.	Clin. Vaccine Immunol.
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