Table 2.

Clinical use and pharmacokinetics of broad-spectrum triazoles, liposomal amphotericin B, and echinocandins in aspergillosis [44, 65]

	Voriconazole	Isavuconazole	Posaconazole	Itraconazole	Liposomal amphotericin B	Caspofungin
Approved indication	Primary therapy: IA Second line: CPA, ABPA	CPA: in case of intolerance/toxicity, resistance, or clinical failure to first and second line (limited data)	Prolonged neutropenia prophylaxis for IA CPA: in case of intolerance/toxicity, resistance, or clinical failure to first and second line (limited data)	Salvage IA therapy ABPA, CPA: primary therapy	IA primary Therapy, empiric febrile neutropenia therapy	IA Salvage or empiric febrile neutropenia therapy
Dosage and formulation	IV: 6 mg/kg Q 12 × 24 h, 4 mg/kg Q12 starting day 2 PO: 200 mg Q12 h	IV: 200 mg Q8 h × 48 h, 200 mg daily starting day 3 PO: 200 mg Q8 h for 48 h, 200 mg daily starting day 3	IV: 300 mg Q12 × 24 h, 300 mg daily starting day 2 Delayed-release: 300 mg Q12 × 24 h, 300 mg daily starting day 2 Oral suspension: 200 mg TID	200 mg IV/PO BID-TID × 3–4d then 200 mg IV/PO QD-BID	IV: 3 mg/kg/day	IV-70 mg daily on day 1, 50 mg daily starting day 2
Half-life (h)	6	110–115	27–35		7–10	9–11
CNS penetration	High	High (animal model)	Low		High (animal model)	Low (animal model)
Metabolism	CYP2C19, CYP2C9, CYP3A4	CYP3A4/5	UGT		Unknown

Abbreviations: ABPA, allergic broncho-pulmonary aspergillosis; BID, bis in die; CPA, chronic pulmonary aspergillosis; CNS, central nervous system; IA, invasive aspergillosis; IV, intravenous; PO, per oral; TID, ter in die.

Adapted from Jenks, J. D., & Hoenigl, M. (2018). Treatment of Aspergillosis. Journal of Fungi, 4(3). 10.3390/jof4030098 [66]