Management of the fungal infections and challenges associated with it

Authors

  • Ashwini Gayke Y. B. Chavan College of Pharmacy, Dr Rafiq Zakaria Campus, Aurangabad 431001, (M.S) India.
  • Ismail Moazzam Y. B. Chavan College of Pharmacy, Dr Rafiq Zakaria Campus, Aurangabad 431001, (M.S) India.

DOI:

https://doi.org/10.56511/JIPBS.2023.10402

Abstract

Fungal infections are becoming more common at an alarming rate, which poses a significant challenge to medical experts. This growth is directly linked to the rise in the number of people with impaired immune systems as a result of modifications to medical practice, including the use of immunosuppressive medications and intense chemotherapy. HIV and other illnesses that impair immunity have also had a role in this issue. Mucous membranes, keratinous tissues, and the skin are all impacted by superficial and subcutaneous fungal infections. This class includes some of the most common skin conditions that impact millions of people globally. They can have crippling consequences on a person's quality of life and, in certain cases, spread to other people or become invasive, even though they are rarely life-threatening. Fungal pathogens employ several tactics to compromise the immune system of the host and escalate infections. The range of antifungal drugs available is used to treat a number of superficial and systemic diseases. The well-established evidence of fungal resistance to most antifungal medicines complicates antifungal therapy and makes disease control challenging. Fungal resistance is caused by a range of genetic alterations, physiological alterations, and selection in the presence of antifungal drugs. The lack of a wide range of antifungal drugs, resistance building, and biofilm-conferred resistance are the main reasons for the need for novel therapeutics and other approaches to enhance treatment outcomes against mycoses.

Keywords:

Fungal skin infections, antifungal therapies, antifungal resistance, pathogenesis, challenges for the management of fungal infections

Downloads

Download data is not yet available.

References

Patel BM, Kuchekar AB, Pawar SR. Emulgel Approach to Formulation Development: A Review. Biosciences Biotechnology Research Asia. 2021;18(3):459 - 65.

Ashara KC, Paun JS, Soniwala MM, Chavada JR, Mori NM. Micro - emulsion based emulgel: a novel topical drug delivery system. Asian pacific journal of tropical disease. 2014; 4:S 27 - 32.

Perlroth J, Choi B, Spell berg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Medical mycology. 2007 ; 45(4):321 - 46.

Lee PP, Lau YL. Cellular and molecular defects underlying invasive fungal infections — revelations from endemic mycoses. Frontiers in immunology. 2017; 28;8: 735.

Rodrigues ML, Nosan Chuk JD. Fungal diseases as neglected pathogens: A wake - up call to public health officials. InAdvances in Clinical Immunology, Medical Microbiology, COVID - 19, and Big Data 2021; 399 - 411. Jenny Stanford Publishing.

Huseynov RM, Javadov SS, Osmanov A, Khasiyev S, Valiyeva SR, Almammadova E, Denning DW. The burden of serious fungal infections in Azerbaijan. Therapeutic Advances in Infectious Disease. 2021; 8: 20499361211043969.

Seiser S, Arzani H, Ayub T, Phan - Canh T, Staud C, Worda C, Kuchler K, Elbe - Bürger A. Native human and mouse skin infection models to study Candida auris - host interactions. Microbes and Infection. 2023; 105234.

Bonifaz A, Ramírez ‐ Tamayo T, Saúl A. Tinea barbae (tinea sycosis): experience with nine cases. The Journal of Dermatology. 2003 ; 30(12):898 - 903.

Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008; 51:2 - 15.

Hoy NY, Leung AK, Metelitsa AI, Adams S. New concepts in median nail dystrophy, onychomycosis, and hand, foot, and mouth disease nail pathology. International Scholarly Research Notices. 2012.

Vlahovic TC. Onychomycosis: evaluation, treatment options, managing recurrence, and patient outcomes. Clinics in podiatric medicine and surgery. 2016; 33(3):305 - 18.

Queller JN, Bhatia N. The dermatologist’s approach to onychomycosis. Journal of Fungi. 2015 ;1(2):173 - 84.

Thomas J, Peterson GM, Christenson JK, Kosari S, Baby KE. Antifungal drug use for onychomycosis. American Journal of Therapeutics. 2019 ; 26(3): e388 - 96.

Gupta AK, Mays RR, Versteeg SG, Shear NH, Piguet V. Update on current approaches to diagnosis and treatment of onychomycosis. Expert Review of Anti - infective Therapy. 2018 ; 16(12):929 - 38.

G upta AK, Versteeg SG, Shear NH. Confirmatory testing prior to initiating onychomycosis therapy is cost - effective. Journal of Cutaneous Medicine and Surgery. 2018 ; 22(2):129 - 41.

I orizzo M, Piraccini BM, Rech G, Tosti A. Treatment of onychomycosis with oral antifungal agents. Expert opinion on drug delivery. 2005 ; 2(3):435 - 4 40 .

K alra MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. American family physician. 20 1 4 ; 89(7):569 - 73 .

F ang J, Huang B, Ding Z. Efficacy of antifungal drugs in the treatment of oral candidiasis: A Bayesian network meta - analysis. The Journal of prosthetic dentistry. 2021 ; 125(2):257 - 65.

Sanglard D, Ischer F, Parkinson T, Falconer D, Bille J. Candida albicans mutations in the ergosterol biosynthetic pathway and resistance to several antifungal agents. Antimicrobial agents and chemotherapy. 2003 ;47(8):2404 - 12.

L eung AK, Barankin B, Lam JM, Leong KF, Hon KL. Tinea versicolor: an updated review. Drugs in Context. 2022 ; 11.

Borelli D, Jacobs PH, Nall L. Tinea versicolor: epidemiologic, clinical, and therapeutic aspects. Journal of the American Academy of Dermatology. 199 1 ; 25(2):300 - 5.

Gupta AK, Bluhm R, Summerbell R. Pityriasis versicolor. Journal of the European Academy of Dermatology and Venereology. 2002 ; 16(1):19 - 33.

Crespo - Erchiga V, Florencio VD. Malassezia yeasts and pityriasis versicolor. Current opinion in infectious diseases. 2002 ; 19(2):139 - 47.

Faergemann J. Pityrosporum species as a cause of allergy and infection. Allergy. 1999 ;54(5):413 - 9.

Gupta AK, Batra R, Bluhm R, Faergemann J. Pityriasis versicolor. Dermatologic clinics. 2003 ; 21(3):413 - 29.

Gupta AK, Kogan N, Batra R. Pityriasis versicolor: a review of pharmacological treatment options. Expert Opinion on Pharmacotherapy. 2005 ; 6(2):165 - 78.

A ste N, Pau M, Pinna AL, Colombo MD, Biggio P. Clinical efficacy and tolerability of terbinafine in patients with pityriasis versicolor: Klinische Wirksamkeit und Verträglichkeit von Terbinafin bei Patented mit Pityriasis versicolor. Mycoses. 1991 ; 34(7 ‐ 8):353 - 7.

Dehghan M, Akbari N, Alborzi N, Sadani S, Keshtkar AA. Single ‐ dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double ‐ blind randomized controlled trial. The Journal of dermatology. 20 10 ; 37(8):699 - 702.

Cullen SI, Frost P, Jacobson C. Treatment of tinea versicolor with a new antifungal agent, ciclopirox olamine cream 1%. Clin Ther. 1985 ;7: 574 - 83.

Elewski BE. Mechanisms of action of systemic antifungal agents. Journal of the American Academy of Dermatology. 1993 1; 28(5): S28 - 34.

Aggarwal K, Jain VK, Sangwan S. Comparative study of ketoconazole versus selenium sulphide shampoo in pityriasis versicolor. Indian Journal of Dermatology, Venereology and Leprology. 2003; 69:86.

Chopra V, Jain VK. Comparative study of topical terbinafine and topical ketoconazole in pityriasis versicolor. Indian Journal of Dermatology, Venereology and Leprology. 2000 ; 66(6):299 - 300.

Balwada RP, Jain VK, Dayal S. A double - blind comparison of 2% ketoconazole and 1% clotrimazole in the treatment of pityriasis versicolor. Indian Journal of Dermatology, Venereology and Leprology. 1996 ; 62(5):298 - 300.

Clayton YM. In vitro activity of terbinafine. Clinical and experimental Dermatology. 1989 ; 14(2):101 - 3.

Ryder NS. Terbinafine: mode of action and properties of the squalene epoxidase inhibition. British Journal of Dermatology. 1992 ; 126(s39):2 - 7.

Villars V, Jones TC. Clinical efficacy and tolerability of terbinafine (Lamisil) — a new topical and systemic fungicidal drug for treatment of dermatomycoses. Clinical and Experimental Dermatology. 1989 ; 14(2):124 - 7.

Villars VV, Jones TC. Special features of the clinical use of oral terbinafine in the treatment of fungal diseases. British Journal of Dermatology. 1992 ;126 :61 - 9.

Faergemann J, Zehender H, Millerioux L. Levels of terbinafine in plasma, stratum corneum, dermis – epidermis (without stratum corneum), sebum, hair and nails during and after 250 mg terbinafine orally once daily for 7 and 14 days. Clinical and experimental dermatology. 1994 ; 19(2):121 - 6.

Cauwenbergh G, De Doncker P, Stoops K, De Dier AM, Goyvaerts H, Schuermans V. Itraconazole in the treatment of human mycoses: review of three years of clinical experience. Reviews of Infectious Diseases. 1987 ; 9(Supplement_1): S146 - 52.

Amer MA . Egyptian Fluconazole Study Group. Fluconazole in the treatment of tinea versicolor. International journal of dermatology. 1997 ; 36(12):940 - 2.

Odds F, Ausma J, Van Gerven F, Westenbergs F, Meerpoel L, Heeres J, Vanden Bossche H, Borgers M. In vitro and in vivo activities of the novel azole antifungal agent R126638. Antimicrobial agents and chemotherapy. 2004 ; 48(2):388 - 91.

Faergemann J, Ausma J, Vandeplassche L, Borgers M. The efficacy of oral treatment with pramiconazole in pityriasis versicolor: a phase II a trial. British Journal of Dermatology. 2007 ; 156(6):1385 - 7.

Sah A, Civelli VF, Donath C, Mandviwala L, Heidari A. A 9 - Month - Old Boy With “3 Months of Croup” a Devil Inside. Journal of Investigative Medicine High Impact Case Reports. 2022 ;10: 23247096211066392.

Kosmidis C, Denning DW. The clinical spectrum of pulmonary aspergillosis. Thorax. 2015 ;70(3):270 - 7.

Tong X, Liu T, Jiang K, Wang D, Liu S, Wang Y, Fan H. Clinical characteristics and prognostic risk factors of patients with proven invasive pulmonary aspergillosis: A single - institution retrospective study. Frontiers in Medicine. 2021 ; 23;8: 756237.

Ziaee A, Zia M, Goli M. Identification of saprophytic and allergenic fungi in indoor and outdoor environments. Environmental monitoring and assessment. 2018 ; 190:1 - 1.

Hoskins A. Genetic and rare diseases information centre (GARD). Medical Reference Services Quarterly. 2022 ; 41(4):389 - 94.

Javaid S, Constance J, Srinivasan R, Yeh N. Traumatic Brain Injury General Principles Definition. Handbook of Pediatric Rehabilitation Medicine. 2022 ; 29:23.

Enoch DA, Yang H, Aliyu SH, Micallef C. The changing epidemiology of invasive fungal infections. Human fungal pathogen identification: methods and protocols. 2017 ; 17 - 65 .

Alothman AF, Althaqafi AO, Matar MJ, Moghnieh R, Alenazi TH et.al. Burden and treatment patterns of invasive fungal infections in hospitalized patients in the Middle East: real - world data from Saudi Arabia and Lebanon. Infection and Drug Resistance. 2017 ; 2:35 - 41.

Rayens E, Norris KA. Prevalence and healthcare burden of fungal infections in the United States. In Open forum infectious diseases 2022 ; (Vol. 9, No. 1, p. ofab593). US: Oxford University Press.

Kmeid J, Jabbour JF, Kanj SS. Epidemiology and burden of invasive fungal infections in the countries of the Arab League. Journal of infection and public health. 2020 ; 13(12):2080 - 6.

Al - Dorzi HM, Sakkijha H, Khan R, Aldabbagh T, Toledo A et.al. Invasive candidiasis in critically ill patients: a prospective cohort study in two tertiary care centers. Journal of intensive care medicine. 2020 ; 35(6):542 - 53.

Osman M, Al Bikai A, Rafei R, Mallat H, Dabboussi F et.al. Update on invasive fungal infections in the Middle Eastern and North African region. Brazilian Journal of Microbiology. 2020 ; 51: 1771 - 89.

A ldardeer NF, Albar H, Al - Attas M, Eldali A, Qutub M et.al. Antifungal resistance in patients with Candidaemia: a retrospective cohort study. BMC infectious diseases. 2020 ; 20 :1 - 7.

Alobaid K, Ahmad S, Asadzadeh M, Mokaddas E, Al - Sweih N et.al. Epidemiology of candidemia in Kuwait: a nationwide, population - based study. Journal of Fungi. 2021 ; 7(8):673.

Al Thaqafi AH, Farahat FM, Al Harbi MI, Al Amri AF, Perfect JR. Predictors and outcomes of Candida bloodstream infection: eight - year surveillance, western Saudi Arabia. International Journal of Infectious Diseases. 2014 ; 21: 5 - 9.

Salah H, Sundararaju S, Dalil L, Salameh S, Al - Wali W et.al. Genomic epidemiology of Candida auris in Qatar reveals hospital transmission dynamics and a South Asian origin. Journal of Fungi. 2021 ; 7(3):240.

Ademe M, Girma F. Candida auris: From multidrug resistance to pan - resistant strains. Infection and drug resistance. 2020 ; 1287 - 94.

Ben Abid F, Salah H, Sundararaju S, Dalil L, Abdelwahab AH et.al. Molecular characterization of Candida auris outbreak isolates in Qatar from patients with COVID - 19 reveals the emergence of isolates resistant to three classes of antifungal drugs. Clin. microbial infection. 2023 .

Badiee P, Hashemizadeh Z. Opportunistic invasive fungal infections: diagnosis & clinical management. The Indian journal of medical research. 2014 ; 139(2):195.

Arvanitis M, Anagnostou T, Fuchs BB, Caliendo AM, Mylonakis E et.al. Molecular and nonmolecular diagnostic methods for invasive fungal infections. Clinical microbiology reviews. 2014 ; 27(3):490 - 526.

K anj SS, Omrani AS, Al - Abdely HM, Subhi A, Fakih RE, Abosoudah I, Kanj H, Dimopoulos G. Survival outcome of empirical antifungal therapy and the value of early initiation: A review of the last decade. Journal of Fungi. 2022 ; 8(11):1146.

Stone NR. Social mycology: Using social media networks in the management of aspergillosis and other mycoses Mycopathologia. 2023 ; 188(5):597 - 601.

Talento AF, Qualie M, Cottom L, Backx M, White PL. Lessons from an educational invasive fungal disease conference on hospital antifungal stewardship practices across the UK and Ireland. Journal of Fungi. 2021 ; 7(10):801.

Tan BH, Chakrabarti A, Patel A, Chua MM, Sun PL et.al . Clinicians’ challenges in managing patients with invasive fungal diseases in seven Asian countries: an Asia Fungal Working Group (AFWG) survey. International Journal of Infectious Diseases. 2020 ; 95: 471 - 80.

Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. European journal of clinical pharmacology. 2013 ; 69: 995 - 1008.

C hen K, Wang Q, Pleasants RA, Ge L, Liu W et.al. Empiric treatment against invasive fungal diseases in febrile neutropenic patients: a systematic review and network meta - analysis. BMC infectious diseases. 2017 ; 17: 1 - 2.

Z hang Y, Sung AH, Rubinstein E, Benigno M, Chambers R et.al. Characterizing patients with rare mucormycosis infections using real - world data. BMC Infectious Diseases. 2022 ; 22(1):1 - 8.

Alothman AF, Al - Musawi T, Al - Abdely HM, Al Salman J, Almaslamani M et.al. Clinical practice guidelines for the management of invasive Candida infections in adults in the Middle East region: expert panel recommendations. Journal of infection and public health. 2014; 7(1):6 - 19.

Alhatmi H, Almansour S, Abanamy R, Akbar A, Abal khail M et.al. Clinical characteristics and outcome of candidemia: Experience from a tertiary referral center in Saudi Arabia. Saudi Journal of Medicine & Medical Sciences. 2022; 10(2):125.

J ohn J, Loo A, Mazur S, Walsh TJ. Therapeutic drug monitoring of systemic antifungal agents: a pragmatic approach for adult and pediatric patients. Expert Opinion on Drug Metabolism & Toxicology. 2019 ; 15(11):881 - 95.

Almohammde S, Alhodian H, Almofareh S, Alshehri S, Almasri DM et.al. A survey of therapeutic drug monitoring in a teaching hospital. Saudi Journal of Biological Sciences. 2021; 28(1):744 - 7.

Miot J, Leong T, Takuva S, Parrish A, Dawood H. Cost - effectiveness analysis of flucytosine as induction therapy in the treatment of cryptococcal meningitis in HIV - infected adults in South Africa. BMC Health Services Research. 2021; 21(1):1 - 1.

Published

31-12-2023
Statistics
297 Views | 708 Downloads

How to Cite

Ashwini Gayke, and Ismail Moazzam. “Management of the Fungal Infections and Challenges Associated With It”. Journal of Innovations in Pharmaceutical and Biological Sciences, vol. 10, no. 4, Dec. 2023, pp. 14-22, doi:10.56511/JIPBS.2023.10402.

Issue

Section

Review Article