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Tables

Table 3.1: Summary of the Mechanisms of Selected Antifungals and Their General Spectrum of Activity

Organism1,2

Triazoles

Echinocandins

Amphotericin B

5-flucytosine

Mechanism of action

Inhibit fungal ergosterol synthesis

Inhibit fungal 1,3-beta-D-glucan synthase

Damages fungal cell membrane by binding to ergosterol

Inhibits fungal RNA and DNA synthesis

Yeasts

Candida albicans

Susceptible

Susceptible

Susceptible

Susceptible

Candida auris

Variable

Variable

Variable

Variable

Candida glabrata

Variable

Susceptible

Susceptible

Susceptible

Candida krusei

Variable

Susceptible

Susceptible

Resistant

Candida parapsilosis

Susceptible

Variable

Susceptible

Susceptible

Candida tropicalis

Susceptible

Susceptible

Susceptible

Susceptible

Cryptococcus neoformans

Susceptible

Resistant

Susceptible

Susceptible

Trichosporon species

Variable

Resistant

Variable

Resistant

Mould

Aspergillus fumigatus

Variable

Susceptible

Susceptible

Resistant

Fusarium species

Variable

Resistant

Variable

Resistant

Scedosporium species

Variable

Resistant

Resistant

Resistant

Mucorales

Variable

Resistant

Susceptible

Resistant

Dimorphic fungus

Talaromyces marneffei

Variable

Resistant

Susceptible

Resistant

Footnotes:

1. The following fungi have been assigned new names: Candida auris as Candidozyma auris, Candida glabrata as Nakaseomyces glabratus, Candida krusei as Pichia kudriavzevii, Candida lusitaniae as Clavispora lusitaniae, Penicillium marneffei as Talaromyces marneffei. Tests routinely used in clinical laboratories may not be able to differentiate among members of the Candida albicans complex (C. albicans, Candida dubliniensis, and Candida africana), Candida parapsilosis complex (Candida parapsilosis, Candida metapsilosis, and Candida orthopsilosis).


2. The information provided serves as a general reference based on selected published articles in the literature. [135,314,320333] Readers should keep in mind that antifungal resistance patterns can vary significantly within a group or genus of fungal pathogens, as well as across different geographical regions and clinical settings. Antifungal resistance can also emerge or evolve over time, making it essential to stay updated on current trends. When available, please refer to the antifungal susceptibility testing results. Beware that breakpoints may not be available for certain organisms. In the event of uncertainty, please consult a clinical microbiologist and infectious disease physician.