Evidence map›Paper›PMID 40908528›Full record

ReviewCurrent medicinal chemistry2026

Azole Antifungals Under Pressure: Therapeutic Challenges and Multifaceted Resistance Mechanisms.

Andre L S Santos, Lívia S Ramos, Thais P Mello, Livia Viganor, Noely M B M Nonato, Raizza E E Pinheiro, Marta H Branquinha

Abstract readReview
PubMed Publisher
In one paragraph

Review in Current medicinal chemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andre L S SantosLaboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Lívia S RamosLaboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Thais P MelloLaboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Livia ViganorDexcom Inc., Quality Assurance Department, South Dobson Road Mesa, Arizona, USA.
Noely M B M NonatoPrograma de Pós- Graduação em Tecnologias Aplicadas a Animais de Interesse Regional, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, PI, Brasil.
Raizza E E PinheiroPrograma de Pós- Graduação em Tecnologias Aplicadas a Animais de Interesse Regional, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, PI, Brasil.
Marta H BranquinhaLaboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fungal infections have increased markedly in both incidence and severity over recent decades, driven in part by the emergence of novel pathogenic species harboring sophisticated resistance mechanisms against commonly used antifungal agents. This alarming trend is especially pronounced with azoles, which remain widely used in clinical settings due to their broad-spectrum activity and favorable oral bioavailability. Azoles exert their antifungal effect by inhibiting lanosterol 14α-demethylase, a key enzyme in the ergosterol biosynthesis pathway, thereby compromising the integrity, fluidity, and functionality of the fungal cell membrane. However, the escalating prevalence of multidrug-resistant fungal strains, particularly those resistant to azoles, has significantly complicated therapeutic strategies and represents a growing threat to global public health. This perspective explores the diverse and increasingly complex mechanisms of azole resistance in clinically relevant fungi, particularly species of Candida and Aspergillus, highlighting the urgent need for enhanced surveillance, novel therapeutic approaches, and responsible antifungal stewardship.

Indexed as

Antifungal AgentsAzolesDrug Resistance, FungalAspergillusCandidaHumansMicrobial Sensitivity TestsMycosesAntifungal AgentsAzolesAntifungal resistanceAspergillusazole antifungalsbiofilmCandida aurischemotherapy

Identifiers

PMID40908528

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.