Amphotericin B was the treatment of choice for patients with systemic fungal disease from the time of its introduction in the late 1950s until recently1. However, since the introduction of ketoconazole in 1981, fluconazole in 1990, and itraconazole in 1992, these antifungal azoles, which unlike amphotericin B can be given orally, have been increasingly used as therapy for the systemic mycoses. Despite the lack of direct comparisons of the efficacy of these drugs and amphotericin B in many fungal diseases, physicians have been influenced by the efficacy, safety, and ease of administration of the azoles. For many of the… © 1994, Massachusetts Medical Society. All rights reserved.