Apport des nouveaux azolés dans la prise en charge des infections fongiques

Azoles have maintained a key role in the treatment of invasive fungal infections which have a growing importance, especially in immunocompromised patients. Because of its good activity and safety, fluconazole has becoming the treatment of choice for invasive candidiasis, except those caused by Candida glabrata and C. krusei. In contrast, itraconazole which is active against Aspergillus sp has limited use for the treatment of invasive mould infections due to the high variability of its bioavailibility. Voriconazole is active against a broad range of fungal pathogens including Aspergillus sp and other molds, except Zygomycetes. Voriconazole is used as first-line therapy for invasive aspergillosis and for infections caused by Fusarium and Scedosporium. It is available in both oral and intravenous administration. Posaconazole has similar in vitro activity but currently only the oral form is available. Its main indication is refractory aspergillosis or intolerance to previous treatment. Posaconzole will be very useful for long-term therapy of zygomycetes infections.