An Overview on Antifungal Drug Therapy: The Constrained Antifungal Arsenal Against Invasive Fungal Diseases and the Escalating Global Health Problem of Antifungal Resistance, Highlighting the Need for Novel Agents and Therapeutic Combinations Against Pathogenic Fungi
Invasive fungal infections (IFIs) have escalated from rare curiosities to a major global health crisis, posing a public health burden comparable to that of malaria or tuberculosis, yet often being tragically overlooked. The medical arsenal for fighting these infections, which can be life-threatening, is severely constrained, relying primarily on a few classes of drugs such as polyenes (like Amphotericin B), azoles, and echinocandins. The situation is further complicated by the rapid emergence of antifungal resistance and unfavorable host effects associated with existing drugs. ****
The mechanism of action for current drugs, such as azoles inhibiting ergosterol synthesis and echinocandins targeting cell wall integrity, highlights the narrow range of vulnerabilities in fungal cells. Discussion should focus on the urgent need for new therapeutic horizons, which include developing novel agents and utilizing effective combination therapies to overcome resistance. Furthermore, the group could debate strategies for increasing awareness and investment in antifungal research, which has historically lagged behind antibacterial research, and the vital role of diagnostics in rapidly identifying the causative fungal pathogen to enable timely, targeted treatment and preserve the efficacy of the limited available drugs.