Antifungal agents: in vitro susceptibility testing, pharmacodynamics, and prospects for combination therapy.

As invasive fungal infections in immunocompromised patients become increasingly important, the field of antifungal chemotherapy continues to evolve rapidly. New agents have entered the clinical arena, providing physicians with a variety of choices for treatment of most infections. Standardized methods for testing the in vitro susceptibility of fungi have become available, and concentration-effect relationships are increasingly explored. Finally, the availability of an entirely new class of antifungal agents is opening new opportunities for combination therapy of infections that are notoriously difficult to treat and carry a dismal prognosis. However, the ongoing progress in these key areas has also made antifungal chemotherapy considerably more complex and susceptible to misconceptions. Continuing efforts in the laboratory and well designed collaborative clinical trials are needed more than ever to turn opportunities into lasting benefit for patients at risk for or suffering from life-threatening invasive mycoses.