Anti-Fungal Drugs

Drugs targeting the cell membrane

Amphotericin B

This drug binds to ergosterols in the cell membrane to make large pores.

This leads to the leakage of cell contents leading to cell death.

It is a broad-spectrum antibiotic which is used for many systemic fungal infections.

It has a low therapeutic index as it also affects human membranes which have cholesterol. 

Nystatin

This has a similar mechanism of action to amphotericin B, allowing it to forming pores in the fungal cell membrane.

It is toxic, so reserved for topical treatments (e.g., for oral thrush as a mouthwash). 

Azole drugs – Itraconazole, Fluconazole, Clotrimazole, Ketoconazole

These inhibit 14a-demethylase which prevents the synthesis of ergosterol in the cell membrane.

The depletion alters fluidity and permeability causing the organism to die.

Terbinafine

This inhibits squalene epoxidase, which inhibits ergosterol synthesis.

It is used in the treatment of superficial fungal nail infections.

Drugs targeting other Features

DNA – Flucytosine

This drug is transported into fungal cells and made into 5-fluoruracil.

This then inhibits thymidylate synthase needed for thymine synthesis stopping fungi making DNA

Spindle – Griseofulvin

This inhibits mitosis by binding to tubulin, thus preventing adequate spindle formation.

This prevents cell division, stopping the fungus from growing.

It is commonly used for dermatophyte (hair and nail) infections. 

Cell Wall – Anidulafungin, capsofungin

This is a group of drugs which inhibit the synthesis of beta-glucan, thus preventing synthesis of the fungal cell wall.

Anidulafungin is especially useful in treating Candida infections.

Disclaimer