The Fungus Among Us: An Antifungal Review

For over two decades, the azole antifungals have been used in clinical practice to treat various fungal infections (TABLE 1). They are categorized into two distinctive classes: the imidazoles and the triazoles. The imidazoles include several agents, most notably clotrimazole, ketoconazole, and miconazole. The triazoles include fluconazole, itraconazole, terconazole, voriconazole, and posaconazole.

 Antifungal resistance – a growing global problem

The spread of antifungal resistance is driven by the widespread use of antifungals in humans and on crops.

Antifungal Agents

There are essentially five workhorse antifungal agents commonly used in critically ill patients.

Antifungal agents for common outpatient paediatric infections

The most common fungal infections in infants and children are mucocutaneous candidiasis, pityriasis versicolor, tinea corporis, tinea pedis, and tinea capitis]. The objective of the present update is to inform clinicians on options for treatment of these symptomatic but non-life-threatening fungal infections in immune-competent hosts, given the wide variety of topical, usually over-the-counter (OTC), and oral prescription drugs available.

Antifungal Agents: Mode of Action, Mechanisms of Resistance, and Correlation of These Mechanisms with Bacterial Resistance

The increased use of antibacterial and antifungal agents in recent years has resulted in the development of resistance to these drugs. The significant clinical implication of resistance has led to heightened interest in the study of antimicrobial resistance from different angles.

Antifungal Drug Repurposing

Control of fungal pathogens is increasingly problematic due to the limited number of effective drugs available for antifungal therapy. Conventional antifungal drugs could also trigger human cytotoxicity associated with the kidneys and liver, including the generation of reactive oxygen species. Moreover, increased incidences of fungal resistance to the classes of azoles, such as fluconazole, itraconazole, voriconazole, or posaconazole, or echinocandins, including caspofungin, anidulafungin, or micafungin, have been documented..

Antifungal drug resistance: an update

The number of antifungal classes is small, and resistance is becoming a much more frequent problem.

Antimicrobial Resistance Series Part 2: Antifungal Resistance

First identified in 2009 in Japan from a man’s earwax, the fungus, Candida auris, has quickly spread around the globe and become one of the most multidrug-resistant and deadliest fungi known.

Fungi and Anti-fungal Agents

There are five main classes of antifungal agents...

The EMPIRICUS trial—the final nail in the coffin of empirical antifungal therapy in the intensive care unit?

Recent randomized controlled trials of prophylactic, pre-emptive or empiric antifungal treatment in high-risk ICU patients have failed to demonstrate a survival benefit.

The Fungus Among Us: An Antifungal Review

For over two decades, the azole antifungals have been used in clinical practice to treat various fungal infections (TABLE 1). They are categorized into two distinctive classes: the imidazoles and the triazoles. The imidazoles include several agents, most notably clotrimazole, ketoconazole, and miconazole. The triazoles include fluconazole, itraconazole, terconazole, voriconazole, and posaconazole.

Tinea Capitis & Kerions

Tinea capitis requires systemic antifungal Rx...

Worldwide emergence of resistance to antifungal drugs challenges human health and food security

The recent rate of emergence of pathogenic fungi that are resistant to the limited number of commonly used antifungal agents is unprecedented. The azoles, for example, are used not only for human and animal health care and crop protection but also in antifouling coatings and timber preservation. The ubiquity and multiple uses of azoles have hastened the independent evolution of resistance in many environments. One consequence is an increasing risk in human health care from naturally occurring opportunistic fungal pathogens that have acquired resistance to this broad class of chemicals.