Azoles

The treatment of invasive aspergillosis remains difficult and until recently only polyenes and itraconazole were viable treatment options. However the development of newer triazoles (voriconazole, posaconazole) has been a welcome addition to the antifungal armamentarium. The proven efficacy of prophylactic posaconazole in high-risk patients, and the use of voriconazole during treatment of invasive aspergillosis have largely replaced amphotericin B and itraconazole use for these indications. Other extended-spectrum triazoles in preclinical development (ravuconazole, isavuconazole, and albaconazole) offer additional pharmacodynamic/pharmacokinetic advantages and will also be reviewed.