Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Species

Abstract

Within the limited antifungal armamentarium, the azole antifungals are the most frequent class used to treat <i>Candida</i> infections. Azole antifungals such as fluconazole are often preferred treatment for many <i>Candida</i> infections as they are inexpensive, exhibit limited toxicity, and are available for oral administration. There is, however, extensive documentation of intrinsic and developed resistance to azole antifungals among several <i>Candida</i> species. As the frequency of azole resistant <i>Candida</i> isolates in the clinical setting increases, it is essential to elucidate the mechanisms of such resistance in order to both preserve and improve upon the azole class of antifungals for the treatment of <i>Candida</i> infections. This review examines azole resistance in infections caused by <i>C. albicans</i> as well as the emerging non-<i>albicans Candida</i> species <i>C. parapsilosis, C. tropicalis, C. krusei</i>, and <i>C. glabrata</i> and in particular, describes the current understanding of molecular basis of azole resistance in these fungal species.