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Flucytosine must not be used as a sole agent in life-threatening fungal infections due to relatively weak antifungal effects and fast development of resistance, but rather in combination with amphotericin B and/or azole antifungals such as fluconazole or itraconazole. Minor infections such as candidal cystitis may
Polyene antimycotics, sometimes referred to as polyene antibiotics, are a class of antimicrobial polyene compounds that target fungi. [1] These polyene antimycotics are typically obtained from certain species of Streptomyces bacteria.
Fluconazole is an antifungal medication used for a number of fungal infections. [5] This includes candidiasis , blastomycosis , coccidioidomycosis , cryptococcosis , histoplasmosis , dermatophytosis , and tinea versicolor . [ 5 ]
Some fungi (e.g. Candida krusei and fluconazole) exhibit intrinsic resistance to certain antifungal drugs or classes, whereas some species develop antifungal resistance to external pressures. Antifungal resistance is a One Health concern, driven by multiple extrinsic factors, including extensive fungicidal use, overuse of clinical antifungals ...
In 1970, flucytosine was available in Africa. [37] A dose of 200 mg/kg per day of flucytosine is associated with more side effects but is not more effective. [citation needed] A single high dose of liposomal amphotericin B with 14 days of flucytosine and fluconazole is recommended by the newest WHO guideline for cryptococcal meningitis. [38]
Rezafungin, sold under the brand name Rezzayo (by Melinta Therapeutics), is a medication used for the treatment of invasive candidiasis. [2] It is an echinocandin antifungal [1] [4] that acts as a fungal β-glucan synthase inhibitor.
These medications, including fluconazole and ketoconazole, are "not effective in 15–20% of cases" [2] against N. glabratus. It is still highly vulnerable to polyene medications such as amphotericin B and nystatin, along with variable vulnerability to flucytosine and caspofungin.
They have fungistatic activity against Aspergillus species and fungicidal activity against most Candida spp., including strains that are resistant to fluconazole. [6] In vitro and mouse models show echinocandins may also enhance host immune responses by exposing highly antigenic beta-glucan epitopes that can accelerate host cellular recognition ...