Which two antifungal classes are preferred for managing advanced fungal infections?

The selection of echinocandins and azoles as the preferred classes for managing advanced fungal infections is grounded in their broad spectrum of activity against a variety of fungal pathogens, particularly the most clinically relevant molds and yeasts.

Echinocandins, such as caspofungin, micafungin, and anidulafungin, work by inhibiting the synthesis of β-glucan, an essential component of the fungal cell wall. This mechanism is particularly effective against Candida species and Aspergillus species, which are common culprits in severe fungal infections. Their safety profile and efficacy make them suitable for patients with invasive candidiasis or those who are refractory to other antifungal therapies.

Azoles, including fluconazole and voriconazole, inhibit the synthesis of ergosterol, a crucial component of the fungal cell membrane. They are widely used in the treatment of various fungal infections, such as cryptococcosis and serious mold infections like aspergillosis. Azoles are particularly valuable for their oral bioavailability and ability to penetrate various tissues, which is crucial for treating systemic infections.

The combination of echinocandins’ effectiveness against fungal cell walls and azoles’ broad antifungal spectrum makes them a