The rapid evolvement of fungal resistance to therapeutic agents merits a
thorough understanding of the molecular and genetic basis of this deleterious
phenomenon. Accumulating efforts expanded our understanding of potential resistance
mechanisms that fungi utilize to combat Antifungal therapy like modification of
biological targets, gene overexpression, efflux pumps, and regulation of transcriptional
factors in response to stress and biofilm formation. The tremendous genomic plasticity
of fungi added to the involvement of a multitude of molecular resistance determinants
and the paucity of novel targets for therapy mandate utilizing innovative approaches to
therapy in parallel to relentless research to develop effective antifungal agents
surmounting rapidly increasing resistance. In this chapter, we illustrate a myriad of
resistance mechanisms along with other relevant topics like the mechanism of action of
antifungal classes, laboratory methods for detecting resistance, clinical susceptibility
testing and future insights.
Keywords: Allylamines, Antifungal agents, Azoles, Echinocandins, Fungal
resistance, Nucleoside Analogues, Polyenes.
