Combinational Antifungal Therapy and Recent Trends in Drug Discovery

Invasive fungal infections are a major problem in immunocompromised patients. This has necessitated an increased interest in the development of new antifungals to treat these life-threatening infections. However, our means of combating fungal infections are still lagging behind those for bacterial infections, due to toxicity and the lower clinical efficacy of available antifungals against some invasive fungal infection. Thus, more efforts are needed in antifungal drug discovery, as well as in developing effective ways of minimizing toxicity and improving delivery of available antifungal drugs. One approach is the effective use of newer antifungal agents in combination therapy against invasive aspergillosis, cryptococcosis and candidiasis. On the other hand, identifying and validating new antifungal drug targets is a prerequisite for new antifungal drug discovery. These new targets might be discovered by both conventional but improved assays and genomic approaches. Also, targeting virulence is expected to be a new paradigm for antifungals. In this chapter, an attempt is made to describe recent progress in combinational therapy and new approaches to antifungal drug discovery.