Nonantifungal Clinical Drug Interventions and Human-Commensal Fungi: What are we Selecting?

Hull, Claire M.; Purdy, Nicola

doi:10.2217/fmb.13.45

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Their prevalence in patients globally is probably underestimated. A very provocative hypothesis has been suggested that nonantifungal drug interventions may in fact select for commensal fungi [75]. As one of many examples put forth, steroid therapy may select for steroid-tolerant commensal fungi.…”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

Antifungal Drug Discovery: The Process and Outcomes

et al. 2014

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New data suggest that the global incidence of several types of fungal diseases have traditionally been under-documented. Of these, mortality caused by invasive fungal infections remains disturbingly high, equal to or exceeding deaths caused by drug-resistant tuberculosis and malaria. It is clear that basic research on new antifungal drugs, vaccines and diagnostic tools is needed. In this review, we focus upon antifungal drug discovery including in vitro assays, compound libraries and approaches to target identification. Genome mining has made it possible to identify fungal-specific targets; however, new compounds to these targets are apparently not in the antimicrobial pipeline. We suggest that ‘repurposing’ compounds (off patent) might be a more immediate starting point. Furthermore, we examine the dogma on antifungal discovery and suggest that a major thrust in technologies such as structural biology, homology modeling and virtual imaging is needed to drive discovery.

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Section: Conclusion and Future Perspectivementioning

confidence: 99%

Antifungal Drug Discovery: The Process and Outcomes

et al. 2014

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Mitigation of Human-Pathogenic Fungi that Exhibit Resistance to Medical Agents: Can Clinical Antifungal Stewardship Help?

2014

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Reducing indiscriminate antimicrobial usage to combat the expansion of multidrug-resistant human-pathogenic bacteria is fundamental to clinical antibiotic stewardship. In contrast to bacteria, fungal resistance traits are not understood to be propagated via mobile genetic elements, and it has been proposed that a global explosion of resistance to medical antifungals is therefore unlikely. Clinical antifungal stewardship has focused instead on reducing the drug toxicity and high costs associated with medical agents. Mitigating the problem of human-pathogenic fungi that exhibit resistance to antimicrobials is an emergent issue. This article addresses the extent to which clinical antifungal stewardship could influence the scale and epidemiology of resistance to medical antifungals both now and in the future. The importance of uncharted selection pressure exerted by agents outside the clinical setting (agricultural pesticides, industrial xenobiotics, biocides, pharmaceutical waste and others) on environmentally ubiquitous spore-forming molds that are lesserstudied but increasingly responsible for drug-refractory infections is considered.

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Nonantifungal Clinical Drug Interventions and Human-Commensal Fungi: What are we Selecting?

Cited by 2 publications

References 22 publications

Antifungal Drug Discovery: The Process and Outcomes

Antifungal Drug Discovery: The Process and Outcomes

Mitigation of Human-Pathogenic Fungi that Exhibit Resistance to Medical Agents: Can Clinical Antifungal Stewardship Help?

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