New options for the treatment of invasive fungal infections.

Fungal infections continue to plague patients undergoing treatment of malignancies. In fact, the incidence as well as the types of fungal species causing serious invasive fungal infections is increasing. Candida infections have become the fourth leading cause of nosocomial blood stream infections. Moreover, in addition to Aspergillus, non-Aspergillus species have emerged as etiologic agents of mold infections in cancer patients. Recently, there have been new and much needed re-enforcements to the antifungal armamentarium. These include the broader triazole antifungal agents that are in clinical trials (posaconazole) or have been recently approved (voriconazole) and the echinocandins, a new antifungal class of which the first approved agent caspofungin is now available. We review the clinical data, side effects, drug interactions, and unique spectrum of activity of these newer antifungal agents against both Candida and clinically relevant mold species.