Medications that eliminate or suppress pathogenic fungi
Explanation
Antifungals (antimycotics) are a category of antimicrobials that are designed to kill or stop the growth of pathogenic fungi【789199571224237†L74-L85】. They are used to treat infections ranging from superficial skin infections to life‑threatening invasive mycoses. Most agents target fungal cell membranes or cell walls; azoles and polyenes disrupt the ergosterol‑rich membrane, echinocandins inhibit β‑1,3‑glucan synthesis in the cell wall, and allylamines block ergosterol synthesis. Because fungal cells are eukaryotic and share many features with human cells, antifungals must be selectively toxic and often have narrow therapeutic windows. Only four classes of antifungals are available in clinical practice【789199571224237†L101-L117】, making the spectrum of treatment options much smaller than for bacterial infections. Overuse or inappropriate dosing can select resistant strains【789199571224237†L135-L151】, and invasive fungal infections continue to rise, particularly among people with weakened immune systems【789199571224237†L101-L117】.
Notable agents and uses
Common azoles include fluconazole and itraconazole for Candida and Cryptococcus infections and voriconazole for aspergillosis. Polyenes such as amphotericin B and nystatin bind ergosterol and are used for severe systemic infections and topical therapy. Echinocandins (e.g., caspofungin) treat candidemia and invasive aspergillosis by inhibiting glucan synthesis, while the allylamine terbinafine is effective against dermatophyte skin infections. Limited diagnostic capability in some settings and fungicide use in agriculture have contributed to antifungal resistance【789199571224237†L135-L151】. Fungi such as Candida auris have become multidrug‑resistant and cause outbreaks in healthcare facilities【789199571224237†L155-L161】.
Antifungals are administered orally, topically, or intravenously depending on the infection. Careful patient monitoring is essential because some drugs can cause nephrotoxicity, hepatotoxicity or drug interactions. Emerging therapies targeting novel pathways are under development but stewardship remains essential.
Related Terms: Antifungal Resistance, Antimicrobials, Antiparasitic, Antivirals, Antibiotics