See also Antifungal spectrum of activity
Polyenes
- Mechanism: bind to ergosterol in the cell membrane and create pores
- Examples: Amphotericin B
Triazoles
- Mechanism: inhibit 14-alpha demethylase (aka. Cyp51p, encoded by Erg11 genes), which is required for synthesis of ergosterol from lanosterol, thus disrupting the cell wall.
- Examples
- Fluconazole: Used as prophylaxis or treatment for Candida species
- Voriconazole: First-line treatment for invasive aspergillosis
- Itraconazole
- Posaconazole: Second-line treatment for invasive aspergillosis, but first-line for prophylaxis
- Isavuconazole
Echinocandins
- Mechanism: disrupt synthesis of beta-glucan in the cell wall by inhibiting 1,3-beta glucan synthase
- Examples
- Micafungin
- Caspofungin: Febrile neutropenia
- Anidulafungin: ICU (high APACHEII), no renal or hepatic dosing needed
