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Adverse reactions to antifungal agents

An increase in the number of immunocompromised hosts has led to an increase in the incidence of fungal infections, predominantly those caused by Candida and Aspergillus spp. The older drugs amphotericin B and flucytosine continue to be used but are associated with major adverse effects such as nephrotoxicity, hepatotoxicity and bone marrow depression, respectively. The older imidazoles used topically for superficial mycoses can produce local reactions. Triazoles as a class can cause hepatotoxicity and are susceptible to drug interactions due to their metabolism by CYP450 enzymes. Visual disturbances and photosensitivity are associated with the use of voriconazole. Echinocandins can provoke infusion-related reactions.