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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 problem, particularly for people with weakened immune systems, causing millions of deaths annually. Current antifungal medications are limited and increasingly ineffective due to drug-resistant fungi. This special issue explores new treatment strategies including novel drugs, combination therapies, and innovative approaches like nanoparticles and antimicrobial peptides to combat these serious infections.

Background

Fungal infections represent a significant global health threat affecting immunocompromised populations and vulnerable groups, with approximately 6.5 million cases of invasive fungal infections occurring annually and resulting in 3.8 million deaths globally. The WHO released its first Fungal Priority Pathogens List in 2022, highlighting the growing threat of fungal infections and rising antifungal resistance. Environmental factors such as climate change, globalization, and the overuse of antifungal medications have contributed to the emergence of multidrug-resistant fungal strains.

Objective

This special issue compilation aims to advance the legacy of research in Medical Mycology and foster the discovery of novel and effective antifungal therapeutic strategies. The editors propose a comprehensive examination of the historical development, current state, and future directions of antifungal therapy, including mechanisms of action and resistance pathways.

Results

The special issue presents findings on novel compounds with activity against mucormycosis, ibrexafungerp’s broad-spectrum activity against resistant Candida and Aspergillus species, rapamycin’s antifungal properties against the Candida haemulonii complex, and antimicrobial peptides derived from Proteus mirabilis showing synergistic effects with fluconazole against drug-resistant Candida species.

Conclusion

A multi-faceted approach integrating innovative drug development, immune-modulatory strategies, combination therapies, and precision diagnostics within a framework of global accessibility and equity is essential to combat rising fungal resistance and secure effective antifungal treatment. Ongoing research, robust surveillance, and strategic stewardship initiatives are critical to safeguard the effectiveness of current antifungal treatments against evolving fungal pathogens.
  • Published in:Current Research in Microbial Sciences,
  • Study Type:Editorial/Review Collection,
  • Source: 10.1016/j.crmicr.2025.100473; PMID: 41140529
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