Wiederhold NP - This study focused on the antifungals for the treatment of invasive fungal infections. Clinically available antifungals primarily target either ergosterol in the fungal cell membrane or 1,3-β-D-glucan in the fungal cell wall. Authors identified several investigational agents that are currently under development. As per observations, each of these investigational agents seemed to have the potential to improve patient outcomes in the treatment of invasive mycoses.

• Clinically available antifungals include the polyene amphotericin B, the triazoles, and the echinocandins.
• Despite advancing the ability to treat patients with invasive mycoses, newer antifungals and improved formulations were often limited by toxicities, drug interactions, and the need for intravenous administration.
• Currently several investigational agents are under development, these agents seemed targeting either ergosterol or 1,3-β-D-glucan in addition to having advantages over currently available drugs.
• These investigational agents included the tetrazoles VT-1129, VT-1161, and VT-1598 that are more specific for fungal Cyp51 and less so for mammalian CYP 450 enzymes, the echinocandin CD101 that has an extended half-life, and the glucan synthase inhibitor SCY-078, which is being developed for oral administration.
• Several agents like inositol acyltransferase AX001, the dihydroorotate dehydrogenase inhibitor F901318, and VL-2397, are also under development; these agents indicated novel mechanisms of action and had structure similar to the siderophore ferrichrome.
• In addition to possibly overcoming the limitations of currently available antifungals, these newer agents could also be less susceptible to mechanisms of resistance that may render antifungals ineffective.