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Polyene Antifungal Agents

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Aspergillosis: From Diagnosis to Prevention

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Abstract

Polyene antifungals have been the cornerstone treatment for invasive aspergillosis for over 40 years. Whilst new treatment options have somewhat changed their role, lipid-associated amphotericin B regimens remain important therapeutic options for aspergillosis due to their broad-spectrum of activity and limited cross-resistance with triazole antifungals. Recent studies have demonstrated the importance of accurate speciation of Aspergillus species during amphotericin B therapy, as some non-fumigatus species, particularly A. terreus and A. flavus are relatively resistant to polyenes. Furthermore, insights into the pharmacokinetic/pharmacodynamic behaviour of the polyenes suggest a limited role for dosage escalation in the treatment of invasive pulmonary aspergillosis. The continued development of new formulation approaches and interest in aerosolised delivery strategies may open new opportunities for the use of polyenes in the prevention of fungal pneumonia caused by a wide range of moulds, including Aspergillus species.

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  1. University of Houston College of Pharmacy and, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Russell E. Lewis

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  1. Porto Alegre, Complexo Hospitalar Santa Casa de, Av. Independencia 155, Porto Alegre, 90035-075, Brazil

    Alessandro Comarú Pasqualotto

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Lewis, R.E. (2009). Polyene Antifungal Agents. In: Comarú Pasqualotto, A. (eds) Aspergillosis: From Diagnosis to Prevention. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2408-4_17

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