What class of antifungal agents does ketoconazole belong to?

Ketoconazole is classified as an azole antifungal agent. Azoles work by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. This disruption of ergosterol production leads to increased membrane permeability and ultimately causes cell death.

Ketoconazole specifically interferes with the enzyme lanosterol 14α-demethylase, which is crucial for converting lanosterol to ergosterol. By targeting this pathway, ketoconazole effectively inhibits the growth of a broad range of fungi, making it useful for treating various superficial and systemic fungal infections.

In contrast, the other classes of antifungals listed, such as echinocandins, polyenes, and allylamines, operate through different mechanisms. Echinocandins disrupt the production of glucan in the fungal cell wall, polyenes bind to ergosterol to form pores in the membrane, and allylamines inhibit an earlier step in the ergosterol biosynthesis pathway. Therefore, the classification of ketoconazole as an azole is based on its mechanism of action and its role within the broader context of antifungal pharmacology.