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Past, present and future of antifungals: Advancements in mechanisms of action and resistance

Summary

Fungal infections are a growing global health threat, especially for people with weakened immune systems, causing millions of deaths annually. Currently available antifungal drugs are limited and increasingly face resistance, making them less effective over time. This special collection of research papers explores new approaches to treating fungal infections, including novel drugs, combination therapies, and alternative treatments to overcome resistance. Scientists and doctors hope these advances will help save more lives by providing better options for treating serious fungal diseases.

Background

Fungal infections have emerged as a significant global health threat affecting immunocompromised populations, with an estimated 6.5 million cases of invasive fungal infections annually resulting in approximately 3.8 million deaths globally. The current antifungal armamentarium remains limited compared to antibacterial agents, comprising four main classes: polyenes, azoles, echinocandins, and pyrimidine analogues. Rising antifungal resistance threatens to undermine advances in fungal disease management, necessitating urgent investigation into novel therapeutic strategies.

Objective

This editorial introduces a special issue dedicated to advancing knowledge in medical mycology and antifungal therapy, focusing on mechanisms of action and resistance. The compilation aims to provide comprehensive insights into past developments, current state, and future directions of antifungal treatments. The special issue seeks to foster discovery of novel and effective antifungal therapeutic strategies.

Results

The special issue includes studies on MMV Pathogen Box compounds against mucormycosis, ibrexafungerp as a novel oral antifungal, rapamycin against Candida haemulonii complex, nanoparticle therapies for cryptococcosis, comprehensive antifungal reviews, resistance analysis in Candida auris and related species, and antimicrobial peptides from Proteus mirabilis with activity against drug-resistant Candida species.

Conclusion

The future of antifungal therapy requires a multi-faceted approach integrating innovative drug development, immune-modulatory strategies, combination therapies, and precision diagnostics within a framework of global accessibility and equity. Ongoing research, robust surveillance, and strategic stewardship initiatives are essential to safeguard antifungal effectiveness against evolving fungal pathogens.
  • Published in:Current Research in Microbial Sciences,
  • Study Type:Editorial/Review Collection,
  • Source: PMID: 41140529, DOI: 10.1016/j.crmicr.2025.100473
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