Immunomodulating effects of antifungal therapy

The action of modern antifungal drugs may not be restricted to their direct fungicidal or fungistatic activity. Recent evidence suggests that antifungals may stimulate or alter the host immune response by mechanisms that may result in enhanced fungal clearance, but with possible increased collateral damage to the host. Dissecting the net impact of antifungal therapy-mediated immunomodulation is difficult because the type and magnitude of these immunostimulatory properties are influenced by the class and type of the drug, the immunologic status of the host, and the specific fungal pathogen. Ultimately, immunopharmacologic considerations may become important in selecting and dosing antifungal therapy for opportunistic mycoses.