Ibrexafungerp (formerly SCY-078 or MK-3118) is a first-in-class triterpenoid antifungal or “fungerp” that inhibits biosynthesis of β-(1,3)-D-glucan in the fungal cell wall, a mechanism of action similar to that of echinocandins. Distinguishing characteristics of ibrexafungerp include oral bioavailability, a favourable safety profile, few drug-drug interactions, good tissue penetration, increased activity at low pH and activity against multi-drug resistant isolates including

C. auris

and

C. glabrata

. In vitro data has demonstrated broad and potent activity against Candida and

Aspergillus

species. Importantly, ibrexafungerp also has potent activity against azole-resistant isolates, including biofilm-forming

Candida

spp., and echinocandin-resistant isolates. It also has activity against the asci form of

Pneumocystis

spp., and other pathogenic fungi including some non-Candida yeasts and non-

Aspergillus

moulds. In vivo data have shown IBX to be effective for treatment of candidiasis and aspergillosis. Ibrexafungerp is effective for the treatment of acute vulvovaginal candidiasis in completed phase 3 clinical trials.