Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas; Department of Dermatology, MD Anderson Cancer Center, Houston, Texas.
Department of Psychology, Rice University, Houston, Texas; Center for Clinical Studies, Houston, Texas.
J Am Acad Dermatol. 2022 Jun;86(6):1207-1226. doi: 10.1016/j.jaad.2021.11.065. Epub 2022 Feb 2.
The available antifungal armamentarium consists of only a few drug classes, many limited in their use by significant toxicities and dangerous drug interactions. Rising opportunistic multidrug-resistant pathogens in the last few decades are further limiting available treatment options in life-threatening invasive fungal diseases. Similarly, antiviral resistance, although uncommon in healthy hosts, remains a challenge in immunocompromised patients with a risk for dissemination and severe disease. As evidenced by a dry pipeline, the gravity of antifungal, antiviral, and antiparasitic resistance has yet to draw the same attention as antibacterial resistance. Resistance disproportionately affects immunocompromised and vulnerable hosts, underscoring the urgent need to develop novel therapeutics. Antifungals, antiparasitics, and antivirals of main significance will be reviewed here, along with resistance concerns and some therapeutic agents under investigation.
现有的抗真菌药物种类有限，只有少数几种药物，其中许多由于毒性大且存在严重的药物相互作用而限制了其应用。在过去几十年中，机会性、多重耐药的病原体不断增加，进一步限制了危及生命的侵袭性真菌感染疾病的治疗选择。同样，抗病毒耐药性虽然在健康宿主中并不常见，但在有传播和严重疾病风险的免疫功能低下患者中仍然是一个挑战。从抗真菌、抗病毒和抗寄生虫耐药性的严重程度尚未引起与抗细菌耐药性相同的关注这一事实可以看出，抗真菌、抗病毒和抗寄生虫耐药性的严重程度尚未引起与抗细菌耐药性相同的关注。耐药性不成比例地影响免疫功能低下和脆弱的宿主，这突显了开发新型治疗方法的迫切需要。本文将对主要的抗真菌药、抗寄生虫药和抗病毒药进行综述，同时探讨耐药性问题和一些正在研究中的治疗药物。
