Invasive fungal infections (IFIs) in the central nervous system (CNS) are particularly hard to treat and are associated with high morbidity and mortality rates. Four chemical classes of systemic antifungal agents are used for the treatment of IFIs (eg meningitis), including polyenes, triazoles, pyrimidine analogues and echinocandins. This review will address all of these classes and discuss their penetration and accumulation in the CNS. Treatment of fungal meningitis is based on the antifungal that shows good penetration and accumulation in the CNS. Pharmacokinetic data concerning the entry of antifungal agents into the intracranial compartments are faulty. This review will provide an overview of the ability of systemic antifungals to penetrate the CNS, based on previously published drug physicochemical properties and pharmacokinetic data, for evaluation of the most promising antifungal drugs for the treatment of fungal CNS infections. The studies selected and discussed in this review are from 1990 to 2019.

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抗真菌药物：中枢神经系统药代动力学的最新综述

中枢神经系统 (CNS) 中的侵袭性真菌感染 (IFI) 特别难以治疗，并且与高发病率和死亡率有关。四种化学类别的全身性抗真菌剂用于治疗 IFI（例如脑膜炎），包括多烯、三唑、嘧啶类似物和棘白菌素。本综述将讨论所有这些类别，并讨论它们在 CNS 中的渗透和积累。真菌性脑膜炎的治疗基于在中枢神经系统中显示出良好渗透和积累的抗真菌剂。关于抗真菌药物进入颅内腔室的药代动力学数据是错误的。本综述将根据先前发表的药物理化特性​​和药代动力学数据，概述全身性抗真菌药穿透中枢神经系统的能力，用于评估治疗真菌性 CNS 感染的最有希望的抗真菌药物。本综述中选择和讨论的研究是从 1990 年到 2019 年。