Voriconazole is primarily indicated for the treatment of serious, invasive fungal infections. These include invasive aspergillosis, candidemia in non-neutropenic patients, and other severe fungal infections such as those caused by Scedosporium and Fusarium species.
Pharmacological Action
Voriconazole is a triazole antifungal agent that works by inhibiting the fungal cytochrome P450 enzyme 14α-sterol demethylase, which is essential for the conversion of lanosterol to ergosterol, a key component of the fungal cell membrane. This inhibition results in the accumulation of toxic methylated sterol precursors, which leads to increased membrane permeability and ultimately, fungal cell death.
Broad Spectrum: Voriconazole exhibits a broad spectrum of activity, including efficacy against Aspergillus species, Candida species, and other opportunistic fungi.
Fungicidal and Fungistatic Effects: It demonstrates fungicidal activity against some fungi, such as Aspergillus, and fungistatic effects against others, such as Candida.
Resistance Mechanisms: While generally effective, fungal resistance can develop through mutations in the target enzyme or through efflux pump mechanisms that reduce intracellular drug concentrations.
