Untitled

Abstract

Fungal infections in critically ill or immunosuppressed patients were increasing in incidence in the human population over the last 1-2 decades. There were few advances in antifungal therapy and, until recently, there were few choices from which to select a treatment for systemic mycoses. However, in the past decade, there have been several developments in this area. Antifungal agents are sufficiently diverse in activity, toxicity, and drug interaction potential. Azoles are synthetic and semi-synthetic compounds. They have a broad spectrum of activity. Triazole antifungals are active to treat an array of fungal pathogens, whereas imidazoles are used almost exclusively in the treatment of superficial mycoses and vaginal candidiasis. Despite the advances, serious fungal infections remain difficult to treat, and resistance to the available drugs is emerging. Use of the currently available azoles in combination with other antifungal agents with different mechanisms of action is likely to provide enhanced efficacy. The present review aims to explore the pharmacology, pharmacokinetics, spectrum of activity, safety, toxicity and potential for drug-drug interactions of the azole antifungal agents. INTRODUCTION: Fungi are common pathogens in critically ill or immunosuppressed patients. Fungal infections (mycoses), though not as frequent as bacterial or viral infections, have nonetheless been increasing in incidence in the human population over the last 1-2 decades. In addition, a number of fungal infections can be difficult to treat, even when the offending organism is identified and appropriate therapy is applied. Fungi have unique characteristics, distinct from their mammalian hosts, allowing for selective targeting of therapeutic drugs.

Combining Miconazole and Domiphen Bromide Results in Excess of Reactive Oxygen Species and Killing of Biofilm Cells

“…We previously identified the quaternary ammonium compound domiphen bromide (DB) as a miconazole (MCZ) potentiator (Tits et al, 2020). MCZ belongs to the azole type of antifungals, which is the preferred antifungal drug class for topical treatment of mucosal biofilm-related Candida infections (Gavarkar et al, 2013). Azoles inhibit the enzyme lanosterol 14alpha-demethylase and most are fungistatic (Sud and Feingold, 1981;Hitchcock et al, 1990).…”