Antifungal drugs: Types, uses, when to seek help (original) (raw)

There are various types of antifungal medications that can treat fungal infections. They are available both over-the-counter and through a prescription, depending on the type of medication.

Molds, yeasts, and mushrooms are all types of fungi. Of the millions of different species of fungi, only a few hundred are responsible for making people sick.

Fungi can cause a variety of conditions. Most of them affect the nails or skin, causing rashes or other skin conditions, but some can cause more serious infections. Fungi can cause meningitis, blood infections, and lung infections.

Anyone who has a weakened immune system who thinks they may have a fungal infection should contact a doctor immediately.

This article will explore the different types of fungal infections, when to see a doctor, and which antifungal drugs are available to treat fungal infections.

Antifungal drugs are the medications people use to treat fungal infections. People can take antifungal drugs orally, apply them topically, or administer them intravenously through an IV drip.

Antifungal medications usually work either by killing the fungal cells or stopping them from growing and multiplying.

Parts of the cell that the antifungal drugs target include the fungal cell membrane and the fungal cell wall. These are both protective parts of the cell that can cause the cell to leak and die when damaged.

Human bodies do not have these structures, meaning antifungal drugs can target the fungi without harming the body’s cells.

Antifungal drugs come in many forms depending on many factors. Specific drugs come in different forms. The type of infection a person has will impact how they receive the drugs.

There are four main types of antifungal drugs.

These are:

• polyenes
• azoles
• allylamines
• echinocandins

Polyenes

These work by altering the wall of the fungal cells to be more porous, thus making them more likely to burst.

Examples of polyenes and the fungal conditions they treat include:

• Nystatin: A topical and oral antifungal that treats candida infections involving the mouth or skin.
• Amphotericin B: Treats a wide variety of fungal conditions, including invasive aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcal meningitis, cryptococcosis, histoplasmosis, mucormycosis, sporotrichosis, and others.

Azoles

Within the category of azole antifungal medication, there are two sub-categories: imidazoles and triazoles.

Some examples of imidazoles and the fungal conditions they treat include:

• Clotrimazole: Skin, oral, and vaginal candida infections.
• Ketoconazole: Systemic fungal infections due to candida, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis.
• Miconazole: Vaginal, skin, and nail infections.

Some examples of triazoles and the fungal conditions they treat include:

• Fluconazole: Used for the treatment of fungal infections due to candida and cryptococcus.
• Isavuconazole: Treatment of invasive aspergillosis and mucormycosis infections.
• Itraconazole: Blastomycosis, aspergillosis, histoplasmosis, candidiasis, and various superficial mycoses.
• Posaconazole: Treats invasive fungal infections due to aspergillosis and candida.
• Voriconazole: Aspergillosis and candida.

Allylamines

Allylamines work by inhibiting an enzyme that the membrane of the cell requires to operate correctly. Without this membrane, the cell is likely to be unable to function.

An example of an allylamine is terbinafine, which treats fungal skin infections.

Echinocandins

These interfere with an enzyme involved in creating the fungal cell wall.

Some examples of echinocandins and the fungal conditions they treat include:

• Anidulafungin: Treats esophageal candidiasis and invasive candidiasis.

• Caspofungin: Aspergillosis, esophageal candidiasis, and invasive candidiasis.

• Micafungin: Esophageal candidiasis and invasive candidiasis.

• Ringworm: People also know ringworm as tinea or dermatophytosis. It is a common infection of the skin caused by any of around 40 different species of fungi. It can occur on the scalp, feet, or anywhere else on the skin.

• Oral thrush: Caused by a yeast called Candida, this infection occurs when something affects the environment inside the mouth, throat, or esophagus.

• Vaginal yeast infection: The yeast that usually lives in the body and on the skin causes this infection. If something disrupts the environment inside the vagina, the yeast can multiply and cause an infection.

• Onychomycosis: Fungal nail infections can occur on the hands, but most commonly occur on the toenails. Fungi cause these infections when they enter the nail through small cracks in the nail or skin around it.

• Coccidioidomycosis: A fungus that lives in the soil in the southwestern United States causes coccidioidomycosis, which is also known as valley fever.

There are some more serious infections that fungi can cause, and these include:

• aspergillosis
• blastomycosis
• cryptococcus gattii infection
• fungal meningitis
• fungal pneumonia
• histoplasmosis
• mucormycosis
• paracoccidioidomycosis
• talaromycosis

These are much rarer, but can be a lot more serious.

• Ringworm: This presents with a ring-shaped rash, and itchy, red, scaly, and cracked skin. Depending on its location, ringworm may cause a person to experience hair loss.
• Oral thrush: White patches may cover the inside of the mouth and throat, including on the tongue. There may also be redness present. A person may experience pain while swallowing or eating.
• Jock itch: People with jock itch may notice scaly, itchy, red spots, usually on the inner sides of the skin folds of their thigh.
• Athlete’s foot: A person with athlete’s foot may notice that they have red, swollen, itchy, and sometimes peeling skin between their toes.
• Vaginal yeast infection: Symptoms may include abnormal vaginal discharge, vaginal itchiness, soreness, pain during penetrative sex, and pain when urinating.
• Onychomycosis: Hands or feet with fungal infections often have thick, yellow, brown, white, or otherwise discolored nails. They may also be fragile or cracked.
• Coccidioidomycosis: Valley fever causes a person to experience fatigue, headache, shortness of breath, night sweats, and muscle ache. They may also have a cough and notice a rash.

A person may be able to resolve a case of ringworm using over-the-counter creams, lotions, or powders. Ringworm on the scalp usually requires treatment using prescription antifungal medications.

Most antifungal medications are prescription-only, so people should seek medical advice if they think that they may have a fungal infection.

People should visit a doctor as soon as possible if they think they have the symptoms of a fungal infection and have a weakened immune system.

This includes people who:

• are living with HIV or AIDS
• are currently in hospital
• have had organ transplants and are taking antirejection medication
• are undergoing cancer treatment
• are taking medications with side effects that can weaken a person’s immune system, such as corticosteroids and tumor necrosis factor inhibitors

It is important to treat fungal infections promptly. Some fungal infections may cause long-term complications, which is especially dangerous in those with weakened immune systems.

Antifungal drugs can treat fungal infections. There are a wide number of different drugs, as there are many different fungi that can cause infections.

Most of the time, healthcare professionals can treat fungal infections easily, but occasionally some may be more serious.

People with weakened immune systems should seek medical attention if they suspect they may have a fungal infection. Anyone with a fungal infection should speak with their doctor if it does not resolve with OTC treatments.