Antifungal resistance occurs when antifungal medicines can’t stop the growth of a fungal infection. People with weak immune systems are most at risk. Superbugs like Candida auris don’t respond to antifungals, which limits treatment options. You can lower the risk of antifungal resistance by taking medicine as prescribed.
Antifungal resistance occurs when an antifungal medication no longer works to treat a fungal infection. The fungus can fight off the medicine’s effects.
This problem is a type of antimicrobial resistance. It occurs when fungi, viruses, bacteria and parasites don’t respond to medications developed to treat them. Your body doesn’t develop antifungal resistance — fungi do. Today, while antifungal medicines may still help you, fewer drugs can treat drug-resistant fungi.
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Antifungal drugs help your body get rid of certain fungal infections. They treat fungal skin infections like yeast infections, athlete’s foot, jock itch and ringworm. Antifungal medicines also manage infections that affect the lungs, brain and blood.
Drug resistance is a serious global health problem. It greatly limits treatment options. If a fungus doesn’t respond to one of three available classes of antifungal drugs, the other options may be less effective. Some drugs cause more severe, potentially toxic side effects.
Nearly 3 million Americans will develop a drug-resistant infection this year. More than 35,000 of them will die.
There are several causes of antifungal resistance:
People who have weakened immune systems are more likely to develop serious fungal infections that can lead to antifungal resistance. This includes people who have:
Certain strains of fungi have become more resistant to antifungal medicines. They’re known as superbugs. These fungi continue to multiply and cause infections even when you take medication.
There are only three classes of antifungal medicines: azoles, echinocandin and polyenes. A fungus that develops resistance to one drug may not respond to any available treatments.
Fungal infections with superbug status include:
Candida auris (C. auris) is a relatively new fungal superbug that first appeared in 2009. It quickly caused problems worldwide and is becoming more common in the United States. Antifungals that typically work on Candida infections don’t always work against this strain. Some strains are multi-drug resistant. These C. auris infections don’t respond to any antifungal drugs.
The fungus causes bloodstream infections that can affect the heart and brain. When this happens, more than 1 in 3 infected people die. The fungus spreads easily in hospitals and nursing homes. People get it through contact with an infected person or contaminated surfaces. It can live on surfaces for several weeks and is difficult to get rid of.
If one class of antifungal drugs doesn’t help, your healthcare provider may try a medicine from a different class. There’s a limited number of effective antifungal treatments. If an infection doesn’t respond to antifungals, your provider may try different medicines. Unfortunately, these drugs may have more severe side effects.
Taking antifungal medicine as prescribed is the best way to prevent antifungal resistance. You can set reminders on your phone so you don’t forget to take it. Contact your healthcare provider if you miss a dose to find out what to do. Often, it’s best to take the next dose as soon as you can.
A note from Cleveland Clinic
Antifungal resistance can occur for many reasons. It sometimes develops spontaneously. Or it may result from antibiotic overuse or misuse of antifungal medicines. People with compromised immune systems are most at risk for developing fungal infections that can lead to antifungal resistance. Some fungi, known as superbugs, don’t respond to standard antifungal treatments. It’s important to take antifungal medicines as prescribed to lower the risk of drug resistance.
Last reviewed by a Cleveland Clinic medical professional on 05/28/2021.
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