Role of Azoles in Antifungal Therapy

The addition of itraconazole and fluconazole to the antifungal armamentarium has resulted in less toxic, easily administered therapy for both endemic and opportunistic mycoses. Itraconazole has become the treatment of choice for most patients with mild-to-moderate histoplasmosis, blastomycosis, and sporotrichosis. Coccidioidomycosis is effectively treated with either itraconazole or fluconazole; fluconazole has become the drug of choice for the treatment of coccidioidal meningitis. In several large cooperative trials, fluconazole has been shown to have a useful role in the treatment of patients with candidemia, localized forms of mucocutaneous and visceral candidiasis, and cryptococcal meningitis.