Antifungal resistance in dermatology

Abstract

Cutaneous fungal infections affect more than one-fourth of world's population. The pathogenesis and severity of fungal infection depend on various immunological and nonimmunological factors. The rampant use of antifungal therapy in immunocompromised individuals marked the onset of antifungal drug resistance. Fungal resistance can be microbiological or clinical. Microbiological resistance depends on various fungal factors which have established due to genetic alteration in the fungi. Clinical resistance is due to host- or drug-related factors. All these factors may cause fungal resistance individually or in tandem. In addition to standardized susceptibility testing and appropriate drug dosing, one of the ways to avoid resistance is the use of combinational antifungal therapy. Combination therapy also offers advantages in increased synergistic action with enhanced spectrum activity. Newer insights into mechanisms of drug resistance will help in the development of appropriate antifungal therapy.

Discovery of a novel and selective fungicide that targets fungal cell wall to treat dermatomycoses: 1,3‐bis(3,4‐dichlorophenoxy)propan‐2‐aminium chloride

“…The development of antimicrobial drug resistance is a relentless fact that is universal in the microbial world. The uncontrolled use of antimycotics in immunocompromised patients marked the onset of antifungal drug resistance . The first reported occurrences of dermatophytic resistance were with griseofulvin .…”

“…The first reported occurrences of dermatophytic resistance were with griseofulvin . Approximately 20% of azole resistance in dermatophytes has been observed in some countries such as the United States and India . Primary resistance of T rubrum to terbinafine in cases of onychomycosis was described in 2003, and it is worth mentioning that in 2018 the resistance of dermatophytes continues being reported .…”

“…Primary resistance of T rubrum to terbinafine in cases of onychomycosis was described in 2003, and it is worth mentioning that in 2018 the resistance of dermatophytes continues being reported . For Candida spp., in patients of chronic mucocutaneous candidiasis, resistance to ketoconazole was first verified in 1980 and the problem of yeast resistance to azoles continues today, almost 40 years after that first report . Also considering the few options of antifungal drugs available, one of the main strategies for improving the mycoses therapy is overcoming antifungal resistance and all limitations involved in the process .…”

“…The uncontrolled use of antimycotics in immunocompromised patients marked the onset of antifungal drug resistance. 17 The first reported occurrences of dermatophytic resistance were with griseofulvin. 18 Approximately 20% of azole resistance in dermatophytes has been observed in some countries such as the United States and India.…”

“…18 Approximately 20% of azole resistance in dermatophytes has been observed in some countries such as the United States and India. 17 Primary resistance of T rubrum to terbinafine in cases of onychomycosis was described in 2003, 19 and it is worth mentioning that in 2018 the resistance of dermatophytes continues being reported. 20 For Candida spp., in patients of chronic mucocutaneous candidiasis, resistance to ketoconazole was first verified in 1980 and the problem of yeast resistance to azoles continues today, almost 40 years after that first report.…”