Topic overview

Start with the big picture

A useful way to approach antifungal pharmacology is to compare each class by its target, representative agents, uses, and important adverse effects. Polyenes such as amphotericin B disrupt fungal membranes, while azoles inhibit ergosterol synthesis. Echinocandins interfere with fungal cell-wall production; flucytosine affects nucleic-acid synthesis, terbinafine blocks squalene epoxidase, and griseofulvin disrupts microtubules. The topic also distinguishes systemic from topical treatment, including the role of topical azoles and allylamines in superficial infections. Clinical associations include amphotericin B’s renal and infusion-related effects, selected azoles’ uses and class effects, and flucytosine-associated myelosuppression. Finally, resistance mechanisms such as target mutations, efflux pumps, and altered ergosterol are introduced.