Review of the Current Management of Urinary Tract Infections due to Fluconazole-Resistant and Non-Albicans Candida Species

AbstractPurpose of ReviewThe management of fungal infections is challenging, especially given the continued increase in fluconazole resistance and prevalence of non-albicansCandida spp. Urinary tract infections due to non-albicans and fluconazole-resistantCandida are particularly problematic given the uncertainty in determining true infection from colonization and the limited number of antifungal agents with adequate penetration to the site of infection. While our understanding of mechanisms of resistance and pharmacokinetics and pharmacodynamics continues to improve, it is combatted by the emergence of novel, difficult-to-manage pathogens such asC. auris. The purpose of this review is to summarize recent data regarding the management of urinary tract infections due to non-albicans and fluconazole-resistantCandida spp. with a focus on mechanisms of resistance, pharmacokinetics and pharmacodynamics, and treatment strategies.Recent FindingsAdvances in molecular techniques have improved our understanding of the mechanisms responsible for antifungal resistance, especially to the echinocandins and azole antifungal classes. Additionally, increased knowledge of the pharmacokinetic and pharmacodynamic properties that govern available antifungal agents has enhanced the ability to optimize dosing, especially for extravascular fungal infections. Unfortunately, these developments in the pre-clinical arena have not been matched by additional high-quality clinical data, and therefore, the ...
Source: Current Fungal Infection Reports - Category: Infectious Diseases Source Type: research