Abstract
We reviewed the licensed antifungal drugs and summarized their mechanisms of action, pharmacological profiles, and susceptibility to specific fungi. Approved antimycotics inhibit 1,3-β-d-glucan synthase, lanosterol 14-α-demethylase, protein, and deoxyribonucleic acid biosynthesis, or sequestrate ergosterol. Their most severe side effects are hepatotoxicity, nephrotoxicity, and myelotoxicity. Whereas triazoles exhibit the most significant drug–drug interactions, echinocandins exhibit almost none. The antifungal resistance may be developed across most pathogens and includes drug target overexpression, efflux pump activation, and amino acid substitution. The experimental antifungal drugs in clinical trials are also reviewed. Siderophores in the Trojan horse approach or the application of siderophore biosynthesis enzyme inhibitors represent the most promising emerging antifungal therapies.
Highlights
Invasive fungal infections represent a global problem resulting in 1.7 million deaths every year [1,2].They are common in immunocompromised patients, as reflected in their chemotherapy, acquired immune deficiency syndrome, and/or organ transplantation [1]
Fluorodeoxyuridine monophosphate by uridine monophosphate pyrophosphorylase. This acid, this compound is incorporated into fungal ribonucleic acid (RNA), resulting in inhibition of compound inhibits the primary source of thymidine in deoxyribonucleic acid (DNA) biosynthesis, thymidylate synthetase, protein synthesis (Figure 3)
Antifungal susceptibility testing (AST) is performed by both reference and commercial methods based on broth microdilution and agar-based assays
Summary
Invasive fungal infections represent a global problem resulting in 1.7 million deaths every year [1,2]. They are common in immunocompromised patients, as reflected in their chemotherapy, acquired immune deficiency syndrome, and/or organ transplantation [1]. The incidence of mucormycosis may exceed 900,000 cases per year after the inclusion of Indian data estimates [4] These infections are associated with high mortality rates. Four antifungal drug classes are used by clinicians and veterinarians for systemic treatment [8] These classes target different parts of the fungal cell. Degrade fungal biofilms or cell wall structures has not been included in the present communication
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