Optimizing antifungal choice and administration

Figures & data

Table 1.  Antifungal spectrum of activity against more common invasive fungal pathogens (data from Lewis, 20111; Denning and Hope, 20105; Dodds Ashley et al., 20067; and Pfaller and Diekema, 20108).

	Polyenes^a	Triazoles				Echinocandins
		Fluconazole	Itraconazole	Voriconazole	Posaconazole	Caspofungin	Micafungin	Anidulafungin
Candida spp.
C. albicans	+	+	+	+	+	+	+	+
C. glabrata	+	±	±	±	±	+	+	+
C. tropicalis	+	+	+	+	+	+	+	+
C. parapsilosis	+	+	+	+	+	±	±	±
C. krusei	+	−	±	+	+	+	+	+
C. lusitaniae	−	+	+	+	+	+	+	+
C. guilliermondii	−	±	±	+	+	±	±	±
Aspergillus spp.
A. fumigatus	+	−	+	+	+	+	+	+
A. flavus	+	−	+	+	+	+	+	+
A. terreus	−	−	+	+	+	+	+	+
A. niger	+	−	±	+	+	+	+	+
A. nidulans	−	−	+	+	+	+	+	+
Cryptococcus neoformans	+	+	+	+	+	−	−	−
Fusarium spp.	±	−	−	+/±	+/±	−	−	−
Scedosporium prolificans	−	−	−	±	±	−	−	−
Scedosporium apiospermum	−/±	−	±	+	+	−	−	−
Mucorales	±	−	−	−	+	−	−	−
Blastomyces spp.	+	+	+	+	+	±^b	±^b	±^b
Histoplasma spp.	+	+	+	+	+	±^b	±^b	±^b
Coccidioides spp.	+	+	+	+	+	±^b	±^b	±^b

Plus signs (+) indicate the antifungal agent has activity against the specified organism; plus/minus signs (±) indicate the agent has variable or slight activity against the specified organism; and minus signs (−) indicate the agent does not have activity against the specified organism.

^aIncludes amphotericin B deoxycholate (AmB) and lipid amphotericin B formulations.

^bVariable echinocandin activity against dimorphic fungi has been described in vitro, depending on whether they are in mycelial or yeast-like form.

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