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Akhil Mangal1, Suresh Kumar Dev2*, Chetna Baregama2, Vijay Singh Kachawa3, Yogesh Kumar Apurva2, Vijay Kumar Bansal4, Vaibhav Rathore5, Mohini Vishwas6, Mohammad Junaid Alam Mansoori2, Ayush Garg2
1Bhai Gurudas College of Pharmacy, Sangrur, Punjab-148002, India
2Venkateshwar Institute of Pharmacy, Sai Tirupati University, Udaipur, Rajasthan-313015, India
3Satyam Institute of Pharmacy, Sai Tirupati University, Udaipur, Rajasthan-313015, India.
4Lachoo Memorial College of Science & Technology “ Pharmacy Wing” Jodhpur, Rajasthan- 342001, India
5Teerthanker Mahaveer College of Pharmacy, Teerthanker Mahaveer University, Delhi Road, NH 9, Moradabad, Uttar Pradesh-244102, India.
6Faculty of Pharmacy, Pacific Academy of Higher Education and Research University, Udaipur, Rajasthan-313001, India
*Address for Corresponding author:
Dr. Suresh Kumar Dev,
Associate Professor,
Venkateshwar Institute of Pharmacy, Sai Tirupati University, Udaipur, Rajasthan-313015, India
Abstract
The restricted number of systemically accessible antifungal drugs is a significant therapeutic challenge for clinicians treating invasive fungal infections because of antifungal resistance. Drug–drug interactions and severe side effects/toxicities may also place restrictions on the use of present medications, making it impossible to increase dosages or prolong usage. The treatment of invasive candidiasis is greatly aided by the azole antifungal fluconazole, which is widely used. But there is rising concern for world health as fluconazole-resistant forms of Candida proliferate. Fluconazole-resistant infections in species such Candida albicans, Candida glabrata, Candida parapsilosis, and Candida krusei are reviewed in this review along with their prevalence, mechanisms of resistance, clinical consequences, and therapy approaches. Mostly, resistance is caused by overexpression of efflux enzyme and mutations in the ERG11 gene, which encodes lanosterol 14-α-demethylase. These elements impede treatment outcomes and decrease medication efficacy. Furthermore, multidrug-resistant strains of C. glabrata and intrinsically resistant species like C. krusei make patient treatment even more difficult. Clinically, fluconazole resistance results in increased rates of death, prolonged hospital admissions, and fewer options for treatment; it frequently necessitates the use of more costly or toxic substitutes such amphotericin B or echinocandins. In order to stop the spread of resistance, this review emphasizes the necessity of antifungal stewardship programs, early identification of resistant strains, and strict infection control procedures. To address the growing issue of fluconazole-resistant Candida infections, research into new antifungal drugs and techniques to prevent resistance is essential.
Keywords: Fluconazole-resistance, Candida parapsilosis, Candida species, Candida albicans, Candida glabrata, and Candida krusei
