Antifungals to treat Candida albicans.

IMPORTANCE OF THE FIELD: Candida species are the fourth leading cause of nosocomial bloodstream infections in the United States. They are a leading cause of invasive fungal infections and are an emerging problem in hospital medicine. AREAS COVERED IN THIS REVIEW: The antifungal armamentarium for the treatment of systemic fungal infections has increased in recent years and now comprises agents from four main drug classes. This article summarizes the role of antifungal agents in the treatment of infections due to Candida albicans (C. albicans). WHAT THE READER WILL GAIN: An extensive summary of currently available antifungal agents active against C. albicans. Clinical trials involving these agents will be discussed. Areas covered include drug pharmacokinetics, mechanisms of action, and toxicities. TAKE HOME MESSAGE: New antifungal agents have contributed to significant advances in the treatment of C. albicans. A detailed knowledge of differences in spectrum of activity, toxicity profiles, bioavailability, formulations, and drug interactions of these agents is required. Despite these recent advances, the attributable mortality rates of candidemia and invasive candidiasis remain very high, reminding us of the importance of strategies for the prevention of these infections.