Amphotericin B and Other Polyenes—Discovery, Clinical Use, Mode of Action and Drug Resistance

Although polyenes were the first broad spectrum antifungal drugs on the market, after 70 years they are still the gold standard to treat a variety of fungal infections. Polyenes such as amphotericin B have a controversial image. They are the antifungal drug class with the broadest spectrum, resistan...

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Bibliographic Details
Main Authors: Hans Carolus, Siebe Pierson, Katrien Lagrou, Patrick Van Dijck
Format: Article
Language:English
Published: MDPI AG 2020-11-01
Series:Journal of Fungi
Subjects:
Online Access:https://www.mdpi.com/2309-608X/6/4/321
Description
Summary:Although polyenes were the first broad spectrum antifungal drugs on the market, after 70 years they are still the gold standard to treat a variety of fungal infections. Polyenes such as amphotericin B have a controversial image. They are the antifungal drug class with the broadest spectrum, resistance development is still relatively rare and fungicidal properties are extensive. Yet, they come with a significant host toxicity that limits their use. Relatively recently, the mode of action of polyenes has been revised, new mechanisms of drug resistance were discovered and emergent polyene resistant species such as <i>Candida </i><i>auris</i><i> </i>entered the picture. This review provides a short description of the history and clinical use of polyenes, and focusses on the ongoing debate concerning their mode of action, the diversity of resistance mechanisms discovered to date and the most recent trends in polyene resistance development.
ISSN:2309-608X