Newer antifungals

Azoles including voriconazole and posaconazole and the echinocandins including caspofungin, micafungin and anidulafungin are the new antifungal drugs introduced in the past decade. These drugs are at least equal and sometimes more efficacious, more convenient to use and less toxic as compared to the earlier antifungals. Voriconazole is the drug of choice for invasive aspergillosis, posaconazole is useful for antifungal prophylaxis and as a salvage drug for zygomycosis and aspergillosis whereas the echinocandins have excellent efficacy against invasive candidiasis. Limited pediatric data, lack of pediatric formulations and high cost are the main limitations.