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. 2022 Mar;29(2):109-112.
doi: 10.1136/ejhpharm-2020-002604.

Antifungal drug resistance: an update

David W Denning  1
Affiliations

Antifungal drug resistance: an update

David W Denning. Eur J Hosp Pharm. 2022 Mar.

Abstract

The number of antifungal classes is small, and resistance is becoming a much more frequent problem. Much greater emphasis needs to be placed on susceptibility testing and antifungal stewardship. Such efforts demonstrably improve survival and overall clinical outcomes. Positively diagnosing a fungal infection with laboratory markers often allows antibacterial therapy to be stopped (ie, anti-tuberculous therapy in chronic pulmonary aspergillosis or antibiotics other than cotrimoxazole in Pneumocystis pneumonia), contributing to antimicrobial resistance control generally. Non-culture based diagnostics for fungal disease are transformational in terms of sensitivity and speed, but only occasionally identify antifungal resistance.

Keywords: leukemia; microbiology; mycology; pulmonary medicine.

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Conflict of interest statement

Competing interests: The author and his family hold Founder shares in F2G Ltd, a University of Manchester spin-out antifungal discovery company. He acts or has recently acted as a consultant to Pulmatrix, Pulmocide, Zambon, Biosergen, Bright Angel Therapeutics, Cipla and Metis. He sits on the DSMB for a SARS CoV2 vaccine trial. In the last 3 years, he has been paid for talks on behalf of Dynamiker, Hikma, Gilead, Merck, Mylan and Pfizer. He is a longstanding member of the Infectious Disease Society of America Aspergillosis Guidelines group, the European Society for Clinical Microbiology and Infectious Diseases Aspergillosis Guidelines group.

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