Two new azoles with structures derived from fluconazole are in clinical trials. They have broad-spectrum activity and are generally well tolerated. Voriconazole (UK-109496) is active against C krusei, C glabrata, and Aspergillus species and also a variety of emerging pathogens . It is available as an oral and intravenous formulation and the drug has high oral bioavailability. Safety is satisfactory and excellent patient tolerance has been reported, although reversible, transient visual side effects have been noted in up to 30% of patients. Phase II clinical trials are in progress for treatment of aspergillosis, moulds, and resistant yeasts; phase III trials are investigating empirical therapy, candidemia, and primary therapy for aspergillosis. Ravuconazole (BMS-207.147)  also has activity against fluconazole-resistant Candida strains and moulds. Intravenous formulations are under development and phase II studies are in progress. An itraconazole derivative, Posaconazole (SCH-56592), has similar broad-spectrum activity, is available only as an oral suspension, and is in phase III clinical trials for treatment of invasive candidal infection, high-risk prophylaxis, and fluconazole-resistant oropharyngeal candidiasis .
Course Number: V035B.043001
This CME Expires on July 1, 2003; no tests will be accepted after this date.
This course is accredited by
The University of Pittsburgh School of Medicine, Center for Continuing Education