ABSTRACT
Candidiasis is an opportunistic mycoses caused by the yeast genus Candida. The genus comprises of many species of which Candidaalbicansis the most common. Candidiasis can cause a wide spectrum of clinical syndromes which include cutaneous candidiasis, gastrointestinal tract candidiasis, respiratory tract candidiasis, genitourinary tract candidiasis, hepatosplenic candidiasis and systemic candidiasis. Conventional antifungal drugs are drugs widely accepted for the treatment of fungal infections. Conventional antifungal drugs used in the treatment of candidiasis belong to three (3) principal classes: the Echinocandins (caspofungin, anidulafungin and micafungin) used for the treatment of systemic candidiasis, the Azoles (fluconazole, voriconazole, posaconazole) and the Polyenes (amphotericin B) for the treatment of cutaneous and chronic mucocutaneous candidiasis. The treatments of these Candida infections with the conventional antifungal drugs vary substantially and are based on the anatomic location of the infection, the patients’ underlying disease and immune status, the patients’ risk factors for infection, and the specific species of Candida responsible for infection, though these speciesare either susceptible or resistant to the drugs, for instance, Candida krusei is susceptible to voriconazole but resistant to fluconazole. Conventional antifungal drugs are an essential key towards the treatment of candidiasis, but require monitoring and modification to ensure adequate treatment of the disease.
INTRODUCTION
Candidiasis is an opportunistic mycoses. It is a fungal infection caused by the yeast genus Candida.Several species of the yeast Candida are capable of causing candidiasis (Brookset al., 2013). Thegenusis composedof organisms such as Candidaalbicans(common cause of candidiasis), Candidaglabrata, Candidaparapsilosis,Candida balanitis, Candida guilliermondii,andCandidakrusei (Pfalleretal.,2007). Candidaspecies belong to the normalmicrobiotaofanindividual’s mucosal oralcavity, gastrointestinal tract andvagina (Shaoetal.,2007),andare manifested by mucocutaneous lesions, fungemia, and sometimes focal infection of multiple sites.Symptoms depend on the site of infection and include dysphagia, skin and mucosal lesions, blindness, vaginal symptoms (itching, burning, discharge), fever, shock, oliguria, renal shutdown, and disseminated intravascular coagulation. Diagnosis is done by histopathology and cultures from normally sterile sites.
Conventional antifungal drugs are drugs widely accepted to fight fungal organisms causing infection and diseases in humans. In the United States, only ten (10) antifungal drugs are currently approved by the Food and Drug Administration (FDA) for the therapy of systemic fungal infections (William, 2000). Conventional antifungal drugs used in the treatment of candidiasis belongto three (3) principal classes: polyenes (amphotericin B), echinocandins(caspofungin, anidulafungin and micafungin) and azoles (fluconazole, voriconazole, posaconazole).Candida species are susceptible, less susceptible or resistant to these antifungal drugs. For instance, some C. glabrataisolates are resistant to fluconazole and allC. krusei isolates are resistant to fluconazole.
The purpose of this presentation is to educate on the widely accepted antifungal drugs for the treatment of candididiasis in different locations of the human body, the Candida species’ susceptibility and resistance to the drugs, and administration of the drugs.
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