TABLE 2.
Structural Classes of Antifungal Agents for Systemic Therapy
| Structure | Mechanism of Action | Primary Use |
|---|---|---|
| Polyenes | ||
| Amphotericin B(AmB) | Disrupt fungal membranes by binding to ergosterol | Systemic and opportunistic mycoses |
| Lipid formulations AmB | ||
| Nystatin | ||
| Allylamines | ||
| Terbinafine | Depress ergosterol biosynthesis by inhibiting squalene oxidase | Treatment of cutaneous dermatophyte infections unresponsive to topical therapy |
| Morpholine | ||
| Amorolfine | Depress biosynthesis of ergosterol by inhibiting cytochrome P450 enzymes | Topical treatment of onychomycosis |
| Nucleoside Analogs | ||
| Flucytosine (in combinations) | Inhibit DNA and RNA synthesis | Combination therapy for cryptococcal disease |
| AZOLES | ||
| Imidazoles: | Depress biosynthesis of ergosterol by inhibiting cytochrome P450 enzymes | Endemic mycoses and systemic opportunistic mycoses |
| Miconazole | ||
| Ketoconazole | ||
| Triazoles: | ||
| Fluconazole | ||
| Itraconazole | ||
| Voriconazole | ||
| Posaconazole | ||
| Ravuconazole | ||
| ECHINOCANDINS | ||
| Micafungin | Depress cell wall formation by inhibiting glucan synthesis | Candidiasis, aspergillosis |
| Caspofungin | ||
| Anidulafungin | ||
| OTHER | ||
| Griseofulvin | Inhibit fungal mitosis by interacting with microtubules | Cutaneous mycoses unresponsive to topical agents |
| SSKI | Unknown | Lymphocutaneous sporotrichosis |