The antifungal pipeline: a reality check

Nat Rev Drug Discov. 2017 Sep;16(9):603-616. doi: 10.1038/nrd.2017.46. Epub 2017 May 12.

Abstract

Invasive fungal infections continue to appear in record numbers as the immunocompromised population of the world increases, owing partially to the increased number of individuals who are infected with HIV and partially to the successful treatment of serious underlying diseases. The effectiveness of current antifungal therapies - polyenes, flucytosine, azoles and echinocandins (as monotherapies or in combinations for prophylaxis, or as empiric, pre-emptive or specific therapies) - in the management of these infections has plateaued. Although these drugs are clinically useful, they have several limitations, such as off-target toxicity, and drug-resistant fungi are now emerging. New antifungals are therefore needed. In this Review, I discuss the robust and dynamic antifungal pipeline, including results from preclinical academic efforts through to pharmaceutical industry products, and describe the targets, strategies, compounds and potential outcomes.

Publication types

  • Review

MeSH terms

  • Animals
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use*
  • Drug Discovery*
  • Drug Evaluation, Preclinical*
  • Drug Resistance, Fungal / drug effects
  • Humans
  • Invasive Fungal Infections / drug therapy*
  • Models, Biological
  • Molecular Targeted Therapy / methods

Substances

  • Antifungal Agents