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<p>All established classes of antifungal agents already show clinically relevant resistance; in <i>Aspergillus fumigatus</i>, agricultural azoles are driving cyp51A mutations. Recently approved drugs such as ibrexafungerp (2021), oteseconazole (2022) and rezafungin (2023) only partially fill therapeutic gaps—what is still missing is a&#xa0;broadly effective “fifth class.” Europe is seeing a&#xa0;growing number of outbreaks caused by <i>Candida auris</i> and other resistant fungal strains, prompting calls for a&#xa0;continent-wide surveillance network. The dual-use problem—the shared use of similar antifungals in human medicine and agriculture—fosters cross-resistance, even against newly developed agents for humans (e.g. olorofim). Environmental hotspots such as compost, wastewater and monoculture fields select for resistant fungal spores, yet legal threshold values for fungicide residues are lacking. Clinical care is under pressure: resistance rates are rising faster than new drugs are approved, and diagnostic capabilities remain patchy.</p>

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Pilzresistenzen – von der Intensivstation bis zum Acker

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月29日

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  • Cornelia Lass-Flörl

摘要

All established classes of antifungal agents already show clinically relevant resistance; in Aspergillus fumigatus, agricultural azoles are driving cyp51A mutations. Recently approved drugs such as ibrexafungerp (2021), oteseconazole (2022) and rezafungin (2023) only partially fill therapeutic gaps—what is still missing is a broadly effective “fifth class.” Europe is seeing a growing number of outbreaks caused by Candida auris and other resistant fungal strains, prompting calls for a continent-wide surveillance network. The dual-use problem—the shared use of similar antifungals in human medicine and agriculture—fosters cross-resistance, even against newly developed agents for humans (e.g. olorofim). Environmental hotspots such as compost, wastewater and monoculture fields select for resistant fungal spores, yet legal threshold values for fungicide residues are lacking. Clinical care is under pressure: resistance rates are rising faster than new drugs are approved, and diagnostic capabilities remain patchy.