What are approach considerations in treating candidiasis?

Updated: Jan 17, 2020
  • Author: Richard Harold "Hal" Flowers, IV, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

While topical antifungal drugs are used most frequently in the treatment of cutaneous C albicans infection, there is concern about rising resistance to these therapies. In particular, reports of Candida strains displaying resistance to azoles and echinocandins have increased in recent years and present a concerning development in the management of invasive candidiasis. [59] Furthermore, the rise of C auris, a pathogenic strain of Candida exhibiting antifungal resistance, is a concerning development and is often found in nosocomial settings. The increasing prevalence of this species is thought to be due to the use of prophylactic systemic antifungal agents such as fluconazole. [60] A 2020 report from the US Centers for Disease Control and Prevention described three chronically ill people in New York who were identified as having pan-resistant C auris infection. [61] The report stated that the pan-resistant C auris infection developed after the patients had received antifungal medications, including echinocandins, a class of drugs that targets the fungal cell wall. As a result, other treatment options are being considered, including antimicrobial peptides, blue/ultraviolet light, and probiotics. [62, 63, 64, 65]


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