ABSTRACT
INTRODUCTION Despite the availability of numerous antifungal agents with potent activity in vitro against a variety of fungal pathogens, treatment outcomes for invasive fungal infections (IFIs) (especially in immunocompromised hosts) remain poor. Numerous strategies have been employed in an attempt to optimize therapy, including use of prophylaxis in high-risk patient populations, early diagnosis, pharmacodynamic-based dosing of antifungals, and the introduction of newer therapies. In an effort to optimize antifungal concentration at the infection site while minimizing the consequences of systemic administration (including adverse reactions and drug interactions), antifungals tested and approved for systemic therapy (i.e., oral and parenteral administration) have been administered in a variety of novel ways (1). While most reports involve administration of amphotericin B, other antifungals (such as flucytosine, nystatin, miconazole and voriconazole) have also been administered in novel methods, including (but not limited to) aerosols, irrigations, and local injections.
