Responding to the emergence of antifungal drug resistance: perspectives from the bench and the bedside. (August 2018)

• Record Type: Journal Article
• Authors: Beardsley, Justin; Halliday, Catriona L; Chen, Sharon C-A; Sorrell, Tania C
• Is Part Of: Future microbiology. Volume 13:Number 10(2018)
• Page Start: 1175
• Page End: 1191
• Publication Date: 2018-08
• Subjects: Microbiology -- Research -- Periodicals; 616.9041
• DOI: 10.2217/fmb-2018-0059
• Languages: English
• ISSNs: 1746-0913

Abstract

The incidence of serious fungal infections is increasing rapidly, and yet the rate of new drugs becoming available to treat them is slow. The limited therapeutic armamentarium is a challenge for clinicians, because the available drugs are often toxic, expensive, difficult to administer, ineffective or a combination of all four. Given this setting, the emergence of resistance is especially concerning, and a review of the topic is timely. Here we discuss antifungal drug resistance in Candida spp. and Aspergillus spp. with reference to the most commonly used first-line antifungal agents – azoles and echinocandins. We review the resistance mechanisms of the leading pathogens, how resistance can be identified in the diagnostic lab and the clinical implications of resistance once detected.