{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:56:11Z","timestamp":1793094971983,"version":"4.5.0"},"reference-count":502,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Microbiol Rev"],"published-print":{"date-parts":[[2024,6,13]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Fungal infections are on the rise, driven by a growing population at risk and climate change. Currently available antifungals include only five classes, and their utility and efficacy in antifungal treatment are limited by one or more of innate or acquired resistance in some fungi, poor penetration into \u201csequestered\u201d sites, and agent-specific side effect which require frequent patient reassessment and monitoring. Agents with novel mechanisms, favorable pharmacokinetic (PK) profiles including good oral bioavailability, and fungicidal mechanism(s) are urgently needed. Here, we provide a comprehensive review of novel antifungal agents, with both improved known mechanisms of actions and new antifungal classes, currently in clinical development for treating invasive yeast, mold (filamentous fungi),\n                    <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                    infections, and dimorphic fungi (endemic mycoses). We further focus on inhaled antifungals and the role of immunotherapy in tackling fungal infections, and the specific PK\/pharmacodynamic profiles, tissue distributions as well as drug-drug interactions of novel antifungals. Finally, we review antifungal resistance mechanisms, the role of use of antifungal pesticides in agriculture as drivers of drug resistance, and detail detection methods for antifungal resistance.\n                  <\/jats:p>","DOI":"10.1128\/cmr.00074-23","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T09:00:25Z","timestamp":1712826025000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":155,"title":["Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease"],"prefix":"10.1128","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-2824","authenticated-orcid":true,"given":"Martin","family":"Hoenigl","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria"},{"name":"BiotechMed-Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Arastehfar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-0144","authenticated-orcid":true,"given":"Maiken Cavling","family":"Arendrup","sequence":"additional","affiliation":[{"name":"Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark"},{"name":"Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7618-725X","authenticated-orcid":true,"given":"Roger","family":"Br\u00fcggemann","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Radboudumc Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands"},{"name":"Radboudumc-CWZ Center of Expertise in Mycology, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-8030","authenticated-orcid":true,"given":"Agostinho","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal"},{"name":"ICVS\/3B\u2019s - PT Government Associate Laboratory, Braga\/Guimar\u00e3es, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Chiller","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW South Wales Health Pathology, Westmead Hospital, Westmead, Australia"},{"name":"The University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7795-4406","authenticated-orcid":false,"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7516-9471","authenticated-orcid":false,"given":"Simon","family":"Feys","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-5607","authenticated-orcid":false,"given":"Jean-Pierre","family":"Gangneux","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence des Mycoses et Antifongiques LA-AspC Aspergilloses chroniques, European Excellence Center for Medical Mycology (ECMM EC), Centre hospitalier Universitaire de Rennes, Rennes, France"},{"name":"Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en sant\u00e9, environnement et travail) UMR_S 1085, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5054-7616","authenticated-orcid":false,"given":"Jeremy A. W.","family":"Gold","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1188-393X","authenticated-orcid":true,"given":"Andreas H.","family":"Groll","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and Infectious Disease Research Program, Center for Bone Marrow Transplantation, University Children\u2019s Hospital, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5207-2159","authenticated-orcid":false,"given":"Jannes","family":"Heylen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6632-9587","authenticated-orcid":false,"given":"Jeffrey D.","family":"Jenks","sequence":"additional","affiliation":[{"name":"Department of Public Health, Durham County, Durham, North Carolina, USA"},{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6656-3648","authenticated-orcid":false,"given":"Robert","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria"},{"name":"BiotechMed-Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8668-1350","authenticated-orcid":false,"given":"Katrien","family":"Lagrou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1023-5597","authenticated-orcid":true,"given":"Fr\u00e9d\u00e9ric","family":"Lamoth","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"},{"name":"Department of Medicine, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Prattes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria"},{"name":"BiotechMed-Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3070-2508","authenticated-orcid":false,"given":"Sarah","family":"Sedik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Wauters","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Medical Intensive Care Unit, University 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Agricultural research service United States Department of agriculture. Available from: https:\/\/www.ars.usda.gov\/oc\/dof\/food-security-how-do-crop-plants-combat-pathogens"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.8b04392"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.730297"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-52512-3.00179-0"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/bs.aambs.2014.09.001"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00960-9"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2022.100885"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.4.501"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1289\/EHP7484"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/g3journal\/jkab427"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00642-21"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-022-01091-2"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6738a5"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1009711"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2017.0635"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy859"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2809.220517"},{"key":"e_1_3_3_54_2","unstructured":"Anonymous. 2022 Ipflufenoquin; pesticide tolerances. 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