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Antibiotics
Special Issues
The Worldwide Problem of Antifungal Resistance: From Basic to Clinic
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The Worldwide Problem of Antifungal Resistance: From Basic to Clinic

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1393

Special Issue Editors

Dr. Max Carlos Ramírez-Soto

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Guest Editor
1. Centro de Investigación en Salud Pública, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru
2. Faculty of Health Sciences, Universidad Tecnológica del Perú, Lima, Peru
Interests: public health; epidemiology; infectious diseases; medical mycology; sporotrichosis; Sporothrix; subcutaneous mycoses; ocular fungal infections; implantation mycoses
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Alexandro Bonifaz

E-Mail Website
Guest Editor
Departamento de Micología, Servicio de Dermatología. Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México CP 06720, Mexico
Interests: cutaneous mycoses (superficial and deep); opportunistic mycoses and antifungal treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Special Issue entitled "The Worldwide Problem of Antifungal Resistance: from Basic to Clinic" aims to present recent research on all aspects of antifungal resistance that threaten human health. Currently, invasive fungal diseases caused by resistant yeasts and moulds (e.g., fungaemia, pulmonary aspergillosis, meningitis, pneumonia) are an important and increasing public health threat. Research into the molecular mechanisms of antifungal resistance is therefore essential to understanding how fungi develop resistance and identifying new drugs. Clinical studies are also essential for monitoring the emergence and spread of this resistance in clinical and community settings. Therefore, new research is needed into the molecular mechanisms and clinical aspects of antifungal resistance, strategies for the targeted use of antifungals, and effective antifungal stewardship programmes to control resistance. In this context, the main topics of interest for this Special Issue include, but are not limited to:

  1. Mechanisms of antifungal resistance in yeasts, moulds and cryptic species;
  2. Emerging species that are resistant to antifungals;
  3. Azole, echinocandin, polyene and multidrug resistance;
  4. The epidemiology and surveillance of antifungal drug resistance;
  5. Factors driving the emergence of antifungal resistance;
  6. Preclinical and clinical research on antifungal resistant fungal pathogens;
  7. Antifungal stewardship programmes;
  8. New antifungal agents against fungal pathogens.

Dr. Max Carlos Ramírez-Soto
Prof. Dr. Alexandro Bonifaz
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antifungal agents
  • antifungal resistance
  • fungal pathogens
  • pharmacology
  • therapeutic use

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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11 pages, 1375 KiB  
Article
Azole Antifungal Consumption in Community Pharmacy Sales in Mainland Portugal: Trend Analysis from 2014 to 2023
by Sofia Moura, Paulo Duarte, Ana Sofia Oliveira, José Martinez-de-Oliveira, Ana Palmeira-de-Oliveira and Joana Rolo
Antibiotics 2025, 14(1), 33; https://doi.org/10.3390/antibiotics14010033 - 4 Jan 2025
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Abstract
Background/Objectives: Excessive or inadequate use of antimicrobial drugs may lead to the emergence of resistant strains. For this reason, it is important to monitor consumption indicators to assess drugs’ utilization over time. This study aimed to analyze the consumption of medically prescribed [...] Read more.
Background/Objectives: Excessive or inadequate use of antimicrobial drugs may lead to the emergence of resistant strains. For this reason, it is important to monitor consumption indicators to assess drugs’ utilization over time. This study aimed to analyze the consumption of medically prescribed azole antifungal drugs in mainland Portugal from 2014 to 2023, focusing on those directed to genital infections: fluconazole, isoconazole, itraconazole, and sertaconazole. Methods: For each drug, the evaluated parameters were the total number of packages, number of packages per 1000 inhabitants, defined daily dose (DDD) per 1000 inhabitants per day, and total costs. For this purpose, we used data from community pharmacies’ sales, which are available through INFARMED (the Portuguese national authority on medicines and health products). Results: Several trends emerged from data analysis. The COVID-19 pandemic negatively affected the consumption of all azole antifungal drugs included in this study. However, after 2020, fluconazole and sertaconazole consumption has been increasing. In the specific case of fluconazole, there was an increase in expenditure, although the total number of packages suffered a decrease over the 10-year study period. Additionally, the defined daily dose (DDD) per 1000 inhabitants per day for fluconazole and itraconazole was lower compared to estimates from the last available survey (2009). Conclusions: Although our findings represent a lesser pressure on fungi, further monitoring is needed to better understand the evolution of fluconazole and itraconazole consumption over time, particularly due to the trends observed in this study. Full article
(This article belongs to the Special Issue The Worldwide Problem of Antifungal Resistance: From Basic to Clinic)
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Review

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18 pages, 2273 KiB  
Review
Terbinafine Resistance in Trichophyton rubrum and Trichophyton indotineae: A Literature Review
by Aditya K. Gupta, Susmita, Hien C. Nguyen, Amanda Liddy, Vasiliki Economopoulos and Tong Wang
Antibiotics 2025, 14(5), 472; https://doi.org/10.3390/antibiotics14050472 - 7 May 2025
Viewed by 62
Abstract
Background/Objectives: Terbinafine has been the gold standard for the management of superficial fungal infections. The etiological agent generally is Trichophyton rubrum (T. rubrum); however, there has been increased reporting of a new terbinafine-resistant strain of the T. mentagrophytes complex (T. [...] Read more.
Background/Objectives: Terbinafine has been the gold standard for the management of superficial fungal infections. The etiological agent generally is Trichophyton rubrum (T. rubrum); however, there has been increased reporting of a new terbinafine-resistant strain of the T. mentagrophytes complex (T. mentagrophytes ITS genotype VIII otherwise known as T. indotineae). Here, we review the epidemiology, clinical features, diagnosis, and treatment of T. rubrum and T. indotineae infections. Methods: We conducted a systematic literature search using PubMed, Embase (Ovid), and Web of Science, resulting in 83 qualified studies with data summarized for clinical features, antifungal susceptibility, and terbinafine resistance mechanisms and mutations. Results: Dermatophytosis is most commonly caused by T. rubrum; however, in certain parts of the world, especially in the Indian subcontinent, T. indotineae infections have been reported more frequently. The majority of T. rubrum isolates remain susceptible to terbinafine (over 60% of isolates show MIC50 and MIC90 < 0.5 µg/mL). In contrast, for T. indotineae, 30% of isolates exhibit MIC50 ≥ 0.5 µg/mL and 80% exhibit MIC90 ≥ 0.5 µg/mL. Frequently detected squalene epoxidase (SQLE) mutations in T. rubrum are Phe397Leu/Ile (41.6%) and Leu393Phe (20.8%); in T. indotineae, these include Phe397Leu (33.0%) and Ala448Thr (24.5%). Other potential terbinafine resistance mechanisms in T. rubrum and T. indotineae are discussed. Conclusions: T. rubrum generally remain susceptible in vitro to terbinafine in contrast to T. indotineae. The essential components of an effective antifungal stewardship emphasize accurate clinical and laboratory diagnosis, susceptibility testing, and appropriate antifungal therapy selection with a multidisciplinary approach. Full article
(This article belongs to the Special Issue The Worldwide Problem of Antifungal Resistance: From Basic to Clinic)
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