Chapter 11 - Antifungal resistance

Abstract

Unlike bacterial resistance where the extensive study is underway, information regarding antifungal resistance is rather limited despite the increasing report of invasive fungal diseases (IFD) causing havoc among immunocompromised patients across the globe in recent past. While resistance to fluconazole, the widely used fungistatic drug, has been reported with increasing frequency in both Candida albicans and the emerging non-albicans Candida spp, azole resistance has also become a booming problem in several species of Aspergillus and other moulds responsible for invasive infections resulting in extensive mortality. With the emergence of multiresistant or pan-resistant strains such as fluconazole and echinocandin-resistant C. glabrata, treatment of IFD has become more challenging for the clinicians who are perhaps already crippled with limited antifungal arsenals and their inherent adverse effects. This chapter attempts to give a comprehensive idea of clinically important antifungal drugs, resistance mechanism, detection technique and status of the antifungal resistance worldwide.