Azole antifungals

What are Azole antifungals?

Azole antifungals are a group of medicines that contain an azole ring and inhibit the growth of a wide range of fungi. They are classified into two groups: those with two nitrogens in the azole ring (the imidazoles; examples include clotrimazole, econazole, ketoconazole, miconazole, and tioconazole) and those with three nitrogens in the azole ring (the triazoles; examples include fluconazole, itraconazole, posaconazole, and voriconazole).

Azole antifungals work by inhibiting the cytochrome P450 dependent enzyme lanosterol 14-alpha-demethylase, which converts lanosterol to ergosterol, the main sterol in the fungal cell membrane. Depletion of ergosterol damages the cell membrane resulting in cell death.

Azole antifungal agents can be used to treat fungal infections of the body and skin, including athlete’s foot, onychomycosis (fungal nail infections), ringworm, and vaginal candidiasis.

Azole antifungal agents have added greatly to the therapeutic options for treatment of systemic fungal infections. The azoles that are available for systemic use can be classified into two groups: the triazoles (fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and the imidazoles (ketoconazole).

Azoles have proven to provide long-lasting control of many target plant pathogens and are categorized to have moderate risk for developing fungicide resistance. Field performances against many fungal pathogens have correspondingly been stable or only moderately reduced over time.