Novel antifungal agents, targets or therapeutic strategies for the treatment of invasive fungal diseases: a review of the literature (2005-2009)

Background: The incidence and prevalence of serious mycoses continues to be a public health problem. Despite aggressive treatment with new or more established licensed antifungal agents, these infections are an important cause of morbidity and mortality, especially in immunocompromised patients. Aims: To critically review the literature regarding important new developments in the field of antifungal therapy both in the English and Spanish versions. Methods: The search of the literature focused on different antifungal targets or mechanisms of action as well as new agents or strategies that could improve antifungal therapy. Results: The review produced a huge amount of information on the use of virulent factors such as growth, filamentation, pathogen tissue clearance, among others, as putative targets of antifungal activity. More recently, the chemical-genetic relationships for licensed agents as well as for other compounds have been provided by the identification of the genes related to the mechanism of action. Conclusions: Although the antifungal activity of numerous compounds has been examined, most of them are at the in vitro or animal models of efficacy stages. Therefore, further investigation should be carried out to realize the true clinical utility of these compounds. (C) 2009 Revista Iberoamericana de Micologia. Published by Elsevier Espana, S.L. All rights reserved.