Key issues concerning fungistatic versus fungicidal drugs

Graybill, J. R.; Burgess, D. S.; Hardin, T. C.

doi:10.1007/bf01575120

Cited by 59Antifungal resistance and susceptibilityFungal Infections and StudiesFungal Plant Pathogen Control

Key issues concerning fungistatic versus fungicidal drugs

Graybill, J. R., Burgess, D. S., Hardin, T. C.·1997·European Journal of Clinical Microbiology & Infectious Diseases

DOI 10.1007/bf01575120

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Abstract

Are there any fungicidal drugs available today? A critical issue in answering this question is that of definition. The simplest, most stringent definitions identify fungistatic drugs as those that inhibit growth, whereas fungicidal drugs kill fungal pathogens. The immunocompetent host is usually far better equipped to eliminate fungal pathogens than the immunosuppressed host. Therefore, it would be especially desirable to have a truly fungicidal drug, one that absolutely kills and fungi, as a treatment option for the immunosuppressed patient. The critical question would be whether a fungicidal drug can be delivered to the target site in a concentration high enough for a sufficient time to reduce the intralesional fungal counts to zero. By this simple definition, there are no fungicidal drugs available today. However, an accepted alternative definition is that often used by the bacteriologist: Fungicidal drugs are those that lead to a reduction of 99.9% of the initial inocula. Although this less restrictive in vitro standard is more easily met, it has serious limitations. Whether the 99.9% kill should be an acceptable standard remains uncertain. As an alternative, the minimum inhibitory concentration, though indicating static activity, has served well; perhaps it should be the only information reported for fungal susceptibility testing.

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Fungicidal therapeutics are expected to improve the clinical outcome of invasive Candida infections, especially in patients with compromised immune systems.
“fungicidal therapeutics are expected to improve the clinical outcome of invasive Candida infections, especially in patients with compromised immune systems [47,48].”
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Self-citation
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Authors: Graybill, J. R., Burgess, D. S., & Hardin, T. C.
Affiliations: The University of Texas at San Antonio Health Science Center (US)
ORCID: Burgess, D. S.
Venue: European Journal of Clinical Microbiology & Infectious Diseases
Publisher: Springer Science and Business Media LLC
Published: 1997-01
Volume: 16
Issue: 1
Pages: 42-50
ISSN: 0934-9723 (ISSN-L)
1435-4373
DOI: 10.1007/bf01575120
OpenAlex: W2081257374
Cited by: 59
References: 60
Citations by year: 2026: 3 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 3
FWCI: 0.88
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
Keywords: antifungal agents, immunocompromised patients, minimum inhibitory concentration
MeSH terms: Adjuvants, Immunologic, Antifungal Agents, Drug Therapy, Combination, Humans, Microbial Sensitivity Tests, Mycoses

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