antifungaalisia

Antifungaalisia, or antifungal agents, are drugs used to treat fungal infections in humans and animals. They can be fungicidal (killing fungi) or fungistatic (inhibiting fungal growth) and are selected based on the organism, site of infection, and patient factors.

Major classes include: Polyenes such as amphotericin B and nystatin bind to ergosterol in fungal cell membranes, creating pores that lead to cell death; they have broad activity but can be toxic, especially in systemic use. Azoles, including fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole, inhibit ergosterol synthesis, impairing membranes; they are widely used, available orally and IV, but can interact with many other drugs and may cause liver effects or QT changes. Echinocandins like caspofungin, micafungin, and anidulafungin inhibit 1,3-β-D-glucan synthesis in the cell wall; they are effective against Candida and have a favorable safety profile but are IV-only. Allylamines (terbinafine, naftifine) inhibit squalene epoxidase and are mainly used for dermatophyte and superficial infections. Flucytosine is a pyrimidine analog that disrupts fungal nucleic acid synthesis; it is often used in combination with amphotericin B due to rapid resistance when used alone. Other topical or niche agents, such as griseofulvin and ciclopirox, target dermatophytes and certain yeasts.

Indications range from superficial infections of the skin, nails, and mucous membranes to serious systemic infections in immunocompromised patients. Resistance can arise via target modification, efflux pumps, or altered sterol synthesis, making susceptibility testing and appropriate combination therapy important. Monitoring typically includes liver and kidney function, drug interactions, and, for some agents, plasma drug levels or cardiac monitoring. Safety considerations vary by drug class and patient comorbidities.