Fungal infections are a growing public health problem. Medscape reports invasive fungi are evolving stronger defenses just as disease-causing bacteria have shown. While antimicrobial resistance receives much of the publicity, it is also recognized that infections from mold and yeast can be every bit as dangerous.
Frustratingly, fungal infections have become more common due, in part, to life-saving advancements, such as organ transplants and cancer therapies, that have expanded the population of immunocompromised people. Every year, infections of molds and yeasts such as Aspergillus and Candida kill millions globally. The attributable 1.5 million death count is more than malaria and on par with rates for tuberculosis. Adding to the problem are emerging drug-resistant strains, such as Candida guris.
Even as rates of fungal infections and drug resistance are increasing, the speed of drug development is not. Researchers are exploring new drug discovery while a few novel antifungals move through clinical trials. Simultaneously, health care organizations are working on improved practices to help stall resistance. [Read More]
Several barriers persist in hampering progress. As eukaryotes, fungi are biochemically far more similar to humans than bacteria. Designing drugs that target them yet won’t also harm a patient is difficult. The FDA is prioritizing an approval process for new antifungals that act in novel ways. As with most anything else, the pandemic has monopolized the attention of pharmaceutical companies who have moved away from other work, including antifungals.
Antifungals demand a greater focus, both by pharmaceutical companies and health care organizations. Pathogens continue to evolve. Every tool available to combat fungi and save lives is needed and welcomed.
“Invasive fungal infections seen by pediatric infectious diseases specialists are some of the most difficult to diagnose and the most difficult to treat of all the serious infections. Multiple newer antifungals with novel mechanisms of action are in the pipeline, offering hope for the first time compared to many years of stagnation limiting us to the classic three major classes. The future is unclear where each new agent will fit into the overall armamentarium, and pediatric studies are yet to be completed for all newer agents to allow us to understand the optimal doses in children.” – Bill Steinbach