Antifungal drugs development

This important antifungal drug (see Chapter 48) is an alternative therapy for visceral leishmaniasis, especially in parts of India with high-level resistance to sodium stibogluconate. Liposomal amphotericin has shown excellent efficacy at a dosage of 3 mg/kg/d intravenously on days 1-5, 14, and 21. Nonliposomal amphotericin (1 mg/kg intravenously every other day for 30 days) is much less expensive, also efficacious, and widely used in India. Amphotericin is also used for cutaneous leishmaniasis in some areas. The use of amphotericin, and especially liposomal preparations, is limited in developing countries by difficulty of administration, cost, and toxicity. 

Besides the development of novel approaches for a fast bacterial detection and identification, many efforts have also been made for the analysis of yeast cells. For clinical purposes rapid methodologies for the diagnosis of invasive yeast infections, e.g., by Candida species, have yet emerged to advise antifungal drugs or to adjust empirical therapy when resistant species are isolated. 

This important antifungal drug (see Chapter 48 Antifungal Agents) is an alternative therapy for visceral leishmaniasis, especially in parts of India with high-level resistance to sodium stibogluconate, but its use is limited in developing countries by difficulty of administration, cost, and toxicity. 

Standardized methods for surveillance of antifungal drug susceptibility have been a recent development (Rex et al, 1993). The M27 protocol of the National Committee for Clinical Laboratory Standards (NCCLS) for testing of yeasts focused on laboratory to laboratory reproducibility and became an approved standard in 1997 (National Committee for Clinical Laboratory Standards, 1997). A modification of M27 for testing of molds has recently been proposed as NCCLS document M38-P (National Committee for Clinical Laboratory Standards, 1998). With these tools, collaborative studies to validate the predictive power of these results have been possible. Interpretive breakpoints for... 

Strategies based on the Simmons-Smith reaction are presently developed for the synthesis of polycyclopropanes of defined absolute and relative stereochemistry in relation with natural product 10, a fascinating natural fatty-acid amide nucleoside that shows promise as an antifungal drug [35, 37],... 

Neutral and acidic GSLs have been characterized from fungal cells and, currently, GSLs are considered as potential targets for the development of antifungal drugs, since many of them differ in structure and function from those observed in human or animal cells. 

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