Week 6: lesson 16,17,18 Anti-fungal drugs

Infectious diseases caused by fungi are called mycoses, and they are often chronic in nature.1 Some mycotic infections are superficial and some involve the skin (cutaneous mycoses extending into the epidermis), but fungi may also penetrate the skin, causing subcutaneous infections. The fungal infections that are most difficult to treat are the systemic mycoses, which are often life threatening. Unlike bacteria, fungi are eukaryotic. They have rigid cell walls composed largely of chitin (a polymer of N-acetylglucosamine) rather than peptidoglycan (a characteristic component of most bacterial cell walls). The fungal cell membrane contains ergosterol rather than the cholesterol found in mammalian membranes. These chemical characteristics are useful in targeting chemotherapeutic agents against fungal infections. Fungal infections are generally resistant to antibiotics used in the treatment of bacterial infections, and, conversely, bacteria are resistant to the antifungal agents. The last two decades have seen a rise in the incidence of fungal infections such that candidemia is a significant cause of septicemia. This increased incidence of fungal infections is associated with greater numbers of patients with chronic immune suppression following organ transplant, from undergoing chemotherapy for myelogenous and solid tumors, or from the human immunodeficiency virus (HIV). During this same period, there have been significant changes in the therapeutic options available to the clinician, including new azoles and echinocandins

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