IBCC Episode 98 - Antifungal Agents

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss antifungal agents commonly used in the ICU, emphasizing the importance of understanding these drugs for empiric therapy. They cover five major antifungal classes: azoles (Fluconazole, Voriconazole, Isovuconazole), echinocandins (Micafungin, Caspofungin, Anidulafungin), and amphotericin, detailing their spectrum of activity against yeasts, molds, and dimorphic fungi. The hosts discuss the pharmacology, dosing, toxicities, and drug interactions of each agent, providing practical examples and highlighting key considerations for treating fungal infections in critically ill patients, including those with specific conditions like hepatic or renal dysfunction. They underscore the shift towards earlier empiric therapy in suspected fungal infections, advocating for the use of safer, broader-spectrum agents like echinocandins when appropriate.