Current Antifungal Drugs

Fungal infections are one of the major causes of fatalities worldwide, causing an estimated 1.5 million deaths annually. Over the past few decades, the incidences of fungal infection have risen with the increase in the cases of immunocompromised patients. However, the impact of fungal diseases on public health is often underestimated. These infections are predominantly caused by the Aspergillus, Candida, and Cryptococcus species. Current therapeutic approaches to treat such fungal infections are limited to five distinct classes of antifungal drugs, viz. polyenes, echinocandins, azoles, pyrimidine analogs, and allylamines. Moreover, a few synthetic molecules are also used as fungicidal agents. Despite the current antifungal armamentarium, the burden of fungal infection is exacerbated by the emergence of drug resistance, host toxicity, and negative interactions with other drugs. The paucity of new antifungal drugs has further complicated the treatment of fungal infections. These limitations provide a rationale for developing novel antifungals preferably with new mechanisms and molecular targets. This chapter thus summarizes the currently used antifungal drugs, their effective combinations, and the challenges inherent to the development of new antifungal drugs. The chapter also addresses strategies to bolster the antifungal pipeline involving emerging new targets for better management of fungal infections.

Keywords: Antifungal agents, Antifungal drugs, Antifungal peptides, Azoles, Clinical trials, Echinocandins, Emerging targets, Ergosterol, Fungal diseases, Fungal infections, Fungal resistance, Mycosis, Multidrug resistance, Polyenes, Pyrimidine analogs.