Table 5.
Properties of systemically available antifungal agents.
| Drug | Formulation | Bioavailability | Safety | Drug-Drug Interaction | Cost | Dosing/Day |
|---|---|---|---|---|---|---|
| Polyenes | ||||||
| D-AmB | IV | NA | Poor | Good | $ | ≤1† |
| LAMB | IV | NA | Good | Good | $$$$ | ≤1† |
| ABCD | IV | NA | Fair | Good | $$$ | ≤1† |
| ABLC | IV | NA | Fair | Good | $$$ | ≤1† |
| Triazoles | ||||||
| Fluconazole | PO, IV | Excellent | Excellent | Good | $(po), $$ (iv) | 1 |
| Itraconazole | PO, IV | Fair/Good | Good | Fair | $$(po), $$$(iv) | 1–2 |
| Voriconazole | PO, IV | Good/excellent* | Good* | Fair* | $$(po), $$$(iv) | 2 |
| Flucytosine | PO, ?IV | Excellent | Fair†† | Good | $ po | 4 |
| Caspofungin | IV | NA | Good* | Good* | $$$$ | 1 |
| Abbreviations: D-AmB, Amphotericin B deoxycholate; LAMB, liposomal Amphotericin B; ABCD, Amphotericin B colloidal dispersion; ABLC, Amphotericin B lipid complex; NA, not applicable | ||||||
| Itraconazole solution has better bioavailability than the capsule form
* Limited clinical data
$ inexpensive, $$ moderately expensive, $$$ expensive, $$$$ very expensive
† IV Amphotericin B products may be given daily or every other day after completion of induction therapy
†† Requires close monitoring of serum levels and clinical toxicity (especially in patients with renal dysfunction) to avoid accumulation and resulting in gut and bone marrow toxicity | ||||||
| Modified with permission from Thomson Current Drugs and Tahsine Mahfouz and Elias Anaissie, Prevention of fungal infections in the immunocompromised host. Current Opinion in Investigational Drugs. 2003 ;4 (8):974 –990.12 | ||||||
| Drug | Formulation | Bioavailability | Safety | Drug-Drug Interaction | Cost | Dosing/Day |
|---|---|---|---|---|---|---|
| Polyenes | ||||||
| D-AmB | IV | NA | Poor | Good | $ | ≤1† |
| LAMB | IV | NA | Good | Good | $$$$ | ≤1† |
| ABCD | IV | NA | Fair | Good | $$$ | ≤1† |
| ABLC | IV | NA | Fair | Good | $$$ | ≤1† |
| Triazoles | ||||||
| Fluconazole | PO, IV | Excellent | Excellent | Good | $(po), $$ (iv) | 1 |
| Itraconazole | PO, IV | Fair/Good | Good | Fair | $$(po), $$$(iv) | 1–2 |
| Voriconazole | PO, IV | Good/excellent* | Good* | Fair* | $$(po), $$$(iv) | 2 |
| Flucytosine | PO, ?IV | Excellent | Fair†† | Good | $ po | 4 |
| Caspofungin | IV | NA | Good* | Good* | $$$$ | 1 |
| Abbreviations: D-AmB, Amphotericin B deoxycholate; LAMB, liposomal Amphotericin B; ABCD, Amphotericin B colloidal dispersion; ABLC, Amphotericin B lipid complex; NA, not applicable | ||||||
| Itraconazole solution has better bioavailability than the capsule form
* Limited clinical data
$ inexpensive, $$ moderately expensive, $$$ expensive, $$$$ very expensive
† IV Amphotericin B products may be given daily or every other day after completion of induction therapy
†† Requires close monitoring of serum levels and clinical toxicity (especially in patients with renal dysfunction) to avoid accumulation and resulting in gut and bone marrow toxicity | ||||||
| Modified with permission from Thomson Current Drugs and Tahsine Mahfouz and Elias Anaissie, Prevention of fungal infections in the immunocompromised host. Current Opinion in Investigational Drugs. 2003 ;4 (8):974 –990.12 | ||||||