Imidazole-derivative azole antifungal. Increases cell membrane permeability in susceptible fungi. Usually fungistatic in action; can be fungicidal at high concentrations or against very susceptible organisms (e.g. Candida). Presumably exerts its antifungal activity by altering cellular membranes, resulting in increased membrane permeability, secondary metabolic effects, and growth inhibition. Interferes with ergosterol synthesis probably via inhibition of C-14 demethylation of sterol intermediates (e.g. lanosterol). Spectrum of antifungal activity includes many fungi (active in vitro and in vivo against C. albicans, C. glabrata, and C. tropicalis; active in vitro against Trichophyton concentricum, T. mentagrophytes, T. rubrum, T. tonsurans, Epidermophyton floccosum, Microsporum canis, M. gypseum, Aspergillus and Cryptococcus), and some Gram-positive bacteria (active in vitro against Staphylococcus aureus, Enterococcus faecalis (formerly Streptococcus faecalis), and S. pyogenes).