Antifungal Therapy for Systemic Fungal Infections
Summary
Systemic fungal infections pose a significant threat to immunocompromised patients, with Candida, Aspergillus and Cryptococcus species accounting for the majority of life-threatening cases. The current therapeutic arsenal comprises three principal drug classes: polyenes (for example amphotericin B), azoles (fluconazole, voriconazole and others) and echinocandins (caspofungin, micafungin). Polyenes act by binding to ergosterol in fungal membranes, creating pores that lead to cell death; azoles inhibit the fungal cytochrome P450 enzyme lanosterol 14α-demethylase, blocking ergosterol synthesis; and echinocandins target β-glucan synthase, compromising cell wall integrity. Treatment selection depends on the infecting species, site of infection, host factors and drug toxicity profiles. Combination therapy and therapeutic drug monitoring have been employed to optimise efficacy and minimise resistance. Despite these advances, challenges persist in drug-related nephrotoxicity, emerging azole resistance, pharmacokinetic variability and high costs. Research is focusing on novel agents with broader spectra, reduced toxicity and affordability, as well as on precision dosing strategies guided by pharmacogenomics. Globally, improving access to essential antifungals and developing stewardship programmes are priorities to reduce mortality and curb the spread of resistant strains.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Antifungal Therapy for Systemic Fungal Infections publication trend
The graph below shows the total number of articles in antifungal therapy for systemic fungal infections across all publications each year (not limited to Nature Index journals).
Technical terms
Candidemia: Bloodstream infection caused by Candida species, often in hospitalised or immunocompromised patients.
Azoles: A class of antifungal agents that inhibit ergosterol biosynthesis, disrupting fungal cell membrane integrity.
Echinocandins: Antifungal drugs that inhibit β-glucan synthase, weakening the fungal cell wall.
Polyenes: Antifungals that bind ergosterol in fungal membranes to form lethal pores, exemplified by amphotericin B.
References
- Pharmacoeconomic analysis by the cost-minimization method of fluconazole drugs recommended for use in candidiosis. Farmatsevtychnyĭ Zhurnal (2020).
- Аналіз асортименту протигрибкових засобів для системного застосування та доказової бази клінічної ефективності і безпеки флуконазолу. American Journal of Health-System Pharmacy (2020).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Nature Index 2026 Regenerative medicine
Regenerative medicine has the potential to transform the treatment of chronic and life-threatening diseases. But major challenges remain, such as overcoming immune rejection and ensuring that new therapies are developed using more inclusive data sets. In this supplement, we explore the discoveries that are driving the field, the barriers that could limit its progress, and the teams and institutions that are making their mark.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.