Pharmacodynamic implications for use of antifungal agents

In the last decade, the relationship between drug dosing and treatment efficacy for life-threatening fungal infections has been clarified by application of pharmacodynamic principles to the study of antifungal agents. Similar to antibacterials, antifungal agents can display static or cidal patterns of activity against pathogenic fungi that can be broadly classified as either concentration-dependent or concentration-independent. The differences between these pharmacodynamic patterns can play an important role in the selection and dosing of antifungal therapy, especially in the treatment of uncommon or resistant mycoses. Knowledge of these pharmacodynamic characteristics may also guide an exploration of unconventional dosing strategies that could prove to be as effective, safe, and more convenient in critically ill or persistently immunosuppressed patients.