Spectrum of antimycotics used in treatment of systemic mycoses is comparatively poor. The oldest and till present
received „golden standard“ is polyen amphotericin B (AmB). It has the widest spectrum of effects and has the lowest
incidence of resistances. However, the therapy can be accompanied by manifestations of toxicity, namely that of
nephrotoxicity. „Lipoid“ form of AmB (Abelcet, Amphocil, AmBisome) with only 20% risk of nephrotoxicity partly
solved the problem. Wider use of these drugs is hindered by their high price. The azoles group (ketoconazole,
fluconazole, itraconazole) today represents the most frequently used group of antimycotics; triazols of the 3rd
generation (variconazole, posaconazole, ravuconazole) broaden the spectrum of effects namely to aspergil infections.
In the future substances with a different target structure will be used. According the mechanism of effect they can
be classified as echinocandins (inhibition of b-glucane synthesis), echinocandins (inhibition of chitin synthesis),
sordarines (selective inhibitors of proteosynthesis), pradimicines (cell lysis by binding on manoproteins). The rising
occurrence of resistance should be coped with inhibitors of the efflux pump (milbemycine). Clinical testing of all
these substances is already in progress, in some of them already in phase III.
amphotericin B, nystatine, azoles, fluconazole, ketoconazole, itraconazole, variconazole, ravucona -
zole, posaconazole, echinocandins, sordarines, pradimicines, efflux pump inhibitors.