In the past, few pharmacologic agents were available for management of
fungal disease. After the early introduction of amphotericin B and mi
conazole, the more recent advent of several new antifungal agents, inc
luding ketoconazole, fluconazole, and itraconazole has expanded the op
tions for treatment of fungal infections. The dramatic increase in num
ber of immunocompromised patients-both those with acquired immunodefic
iency syndrome (AIDS) and those with immunosuppression for other reaso
ns, such as organ transplantation-emphasizes the importance of therape
utic strategies for combating systemic mycoses. In this article, we re
view our personal recommendations for treating histoplasmosis, blastom
ycosis, coccidioidomycosis, and cryptococcosis, along with other less
common fungal infections, and discuss the efficacy and toxic effects o
f the various antifungal drugs.