Treatment and clinical management of candidiasis: a brief review of the literature
DOI:
https://doi.org/10.18378/rebes.v14i3.10540Keywords:
Antifungals, Mycology, PharmacologyAbstract
Candida species are commensal and are therefore part of the normal human flora and are located on the skin and in the gastrointestinal and genital tracts. However, it can also cause various infections in susceptible patients, including elderly, hospitalized, or immunosuppressed patients. This work sought to evaluate the current scenario of antifungal treatments available for each type of candidiasis, focusing on the characteristics of each clinical approach and their limitations. Furthermore, it presents new perspectives in the development of new compounds with antifungal activity and the challenges for expanding currently available therapeutic alternatives. To this end, searches were carried out in the following databases: Scielo, Pubmed and Google Scholar in the period between February and May 2024. The keywords were used: Antifungals, candidiasis classification, invasive candidiasis and new antifungals treatments. Invasive Candida infection is one of the most common fungal infections worldwide and is considered one of the main causes of healthcare-associated infections. Furthermore, the therapeutic arsenal against candidiasis basically includes four classes of antifungals: polyenes, azoles, echinocandins and flucytosine, each of which presents problems that limit its clinical use. Therefore, it is essential to identify biochemical mechanisms unique to fungi as drug discovery targets in order to develop other generations of antifungal therapies.
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AHMADI, A., MOHAMMADNEJADI, E., KARAMI, P., & RAZZAGHI-ASL, N. Current status and structure activity relationship of privileged azoles as antifungal agents (2016–2020). International Journal of Antimicrobial Agents, v. 59, n. 3, p. 106518, 2022.
AKASH, PATIL.; SOUMYAJIT, MAJUMDAR. Echinocandins in antifungal pharmacotherapy, Journal of Pharmacy and Pharmacology, v. 69, n. 12, p. 1635–1660, 2017.
ALDHOLMI, M. et al. A decade of antifungal leads from natural products: 2010–2019. Pharmaceuticals, v. 12, n. 4, p. 182, 2019.
ANTINORI, S. et al. Candidemia and invasive candidiasis in adults: A narrative review. European journal of internal medicine, v. 34, p. 21-28, 2016.
ATALLAH, A.; CASTRO, N. Aldemar Araujo. Revisão sistemática da literatura e metanálise. Medicina baseada em evidências: fundamentos da pesquisa clínica. São Paulo: Lemos-Editorial, p. 42-48, 1998.
BECK, K. R.; ODERMATT, A. Antifungal therapy with azoles and the syndrome of acquired mineralocorticoid excess. Molecular and Cellular Endocrinology, v. 524, p. 111168, 2021.
BENITEZ, L. L.; CARVER, P. L. Adverse effects associated with long-term administration of azole antifungal agents. Drugs v. 79, n. 8, p. 833–53, 2019.
FERNANDES, M. C.; DASILVA, D.; HARANAHALLI, K.; MCCARTHY, J. B.; MALLAMO, J.; OJIMA, I.; DEL POETA, M. The Future of Antifungal Drug Therapy: Novel Compounds and Targets. Antimicrob Agents Chemother. v. 65, n. 2, p. 10.1128/aac. 01719-20, 2021.
GÓMEZ-LÓPEZ A. Antifungal therapeutic drug monitoring: focus on drugs without a clear recommendation. Clinical Microbiology and Infection, v. 26, n. 11, p. 1481-1487, 2020.
GONZALEZ-LARA, M. F.; OSTROSKY-ZEICHNER, L. Invasive Candidiasis. Seminars in respiratory and critical care medicine. Thieme Medical Publishers, 2020. p. 003-012.
HOENIGL, M.; SPRUTE, R.; EGGER, M.; ARASTEHFAR, A.; CORNELY, O. A.; KRAUSE, R.; LASS-FLÖRL, C.; PRATTES, J.; SPEC, A.; THOMPSON, G. R.; WIEDERHOLD, N.; JENKS, J. D. The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, and Rezafungin. Drugs. v. 81, n. 15, p. 1703-1729, 2021.
JOHNSON, M. D. Antifungals in Clinical Use and the Pipeline. Infectious Disease Clinics, v. 35, n. 2, p. 341-371, 2021.
LEE, H,; LEE, D. G. Novel Approaches for Efficient Antifungal Drug Action. Jounal Microbiol Biotechnol. 2018
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Flucytosine. [Updated 2018 Feb 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548624/
LOGAN, A.; WOLFE, A.; WILLIAMSON, J.C. Antifungal Resistance and the Role of New Therapeutic Agents. Current Infectious Disease Reports, v. 24, n. 9, p. 105-116, 2022.
LÓPEZ-MARTÍNEZ, R. Candidosis, a new challenge. Clinics in dermatology, v. 28, n. 2, p. 178-184, 2010.
MAZU, K. T.; BRICKER, A. B.; FLORES-ROZAS, H.; ABLORDEPPEY, Y. S. The mechanistic targets of antifungal agents: an overview. Mini reviews in medicinal chemistry, v. 16, n. 7, p. 555-578, 2016.
MCCARTY, TODD P.; PAPPAS, PETER G. Invasive candidiasis. Infectious Disease Clinics, v. 30, n. 1, p. 103-124, 2016.
MCCARTY, TODD P.; WHITE, CAMERON M.; PAPPAS, PETER G. Candidemia and invasive candidiasis. Infectious Disease Clinics, v. 35, n. 2, p. 389-413, 2021.
MOHAMED, A. A.; LU, X. L.; MOUNMIN, F. A. Diagnosis and Treatment of Esophageal Candidiasis: Current Updates. Canadian Journal of Gastroenterology and Hepatology, v. 2019, 2019.
PADDA, I. S.; PARMAR, M. Flucytosine. [Updated 2023 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024.
PAIVA, J. A.; PEREIRA, J. M. Treatment of invasive candidiasis in the era of Candida resistance. Current Opinion in Critical Care v. 29, n. 5, p. 457-462, 2023.
PAPPAS, P. G.; KAUFFMAN, C. A.; ANDES, D. R et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clinical infectious diseases, v. 62, n. 4, p. e1-e50, 2016.
PAPPAS, P.; LIONAKIS, M.; ARENDRUP, M. et al. Invasive candidiasis. Nature Reviews Disease Primers, v. 4, n. 1, p. 1-20, 2018.
PIANALTO, K. M.; ALSPAUGH, J. A. New horizons in antifungal therapy. Journal of Fungi, v. 2, n. 4, p. 26, 2016.
QUILES-MELERO, I.; GARCÍA-RODRÍGUEZ, J. Antifúngicos de uso sistémico [Systemic antifungal drugs]. Revista Iberoamericana de Micología, v. 38, n. 2, p. 42-46, 2021.
RAMPONE, S.; PAGLIARULO, C.; MARENA, C.; ORSILLO, A.; IANNACCONE, M.; TRIONFO, C.; SATERIALE, D.; PAOLUCCI, M. In silico analysis of the antimicrobial activity of phytochemicals: towards a technological breakthrough. Comput Methods Programs Biomed. v. 200, p. 105820, 2021.
SAWANT, B.; KHAN, T. Recent advances in delivery of antifungal agents for therapeutic management of candidiasis. Biomedicine & Pharmacotherapy, v. 96, p. 1478-1490, 2017.
SCORZONI, L.; FUCHS, B. B.; JUNQUEIRA, J. C.; MYLONAKIS, E. Current and promising pharmacotherapeutic options for candidiasis. Expert opinion on pharmacotherapy, v. 22, n. 7, p. 887-888, 2021.
SIGERA, L. S. M.; DENNING, D. W. Flucytosine and its clinical usage. Therapeutic advances in infectious disease, v. 10, p. 20499361231161387, 2023.
SOUSA, F.; NASCIMENTO, C.; FERREIRA, D.; REIS, S.; COSTA, P. Reviving the interest in the versatile drug nystatin: A multitude of strategies to increase its potential as an effective and safe antifungal agent. Advanced Drug Delivery Reviews, p. 114969, 2023.
STEIMBACH, L. M. et al. Efficacy and safety of amphotericin B lipid‐based formulations—A systematic review and meta‐analysis. Mycoses, v. 60, n. 3, p. 146-154, 2017.
SZYMAŃSKI, M.; CHMIELEWSKA, S.; CZYŻEWSKA, U.; MALINOWSKA, M.; TYLICKI, A. Echinocandins - structure, mechanism of action and use in antifungal therapy. Journal of Enzyme Inhibition and Medicinal Chemistry, v. 37, n. 1, p. 876-894, 2022.
TORTORANO, A. M.; PRIGITANO, A.; MORRONI, G.; BRESCINI, L.; BARCHIESI, F. Candidemia: Evolution of Drug Resistance and Novel Therapeutic Approaches. Infection and Drug Resistance, p. 5543-5553, 2021.
TVERDEK, F. P.; KOFTERIDIS, D.; KONTOYIANNIS, D. P. Antifungal agents and liver toxicity: a complex interaction. Expert Review of Anti-Infective Therapy, v. 14, n. 8, p. 765-776, 2016.
WOŹNIAK, M. Antifungal agents in wood protection—A review. Molecules, v. 27, n. 19, p. 6392, 2022.
ZHU, P.; LI, Y.; GUO, T.; LIU, S.; TANCER, R. J.; HU, C.; ZHAO, C.; XUE, C.; LIAO, G. New antifungal strategies: Drug combination and co-delivery. Advanced Drug Delivery Reviews. p. 114874, 2023.
ZIDA, A.; BAMBA, S.; YACOUBA, A.; OUEDRAOGO-TRAORE, R.; GUIGUEMDÉ, R. T. Anti-Candida albicans natural products, sources of new antifungal drugs: A review. Journal de mycologie medicale, v. 27, n. 1, p. 1-19, 2017.
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