Related Experiment Video

Updated: Jul 17, 2026

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
08:45

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

Published on: December 28, 2017

Risk of resistance associated with fluconazole prophylaxis: systematic review

Luc P Brion1, Smart E Uko, David L Goldman

  • 1Division of Neonatology, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, USA. brionlp@aol.com <brionlp@aol.com>

The Journal of Infection
|January 24, 2007
PubMed
Abstract

Insights

Fluconazole prophylaxis increases the risk of fungal colonization with resistant strains, but does not significantly impact invasive fungal infections. Further research is needed on breakthrough infections.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Fluconazole prophylaxis is known to reduce fungal colonization and invasive infections in high-risk patients.
  • Concerns exist regarding the emergence of azole-susceptible dose-dependent or resistant fungal strains with prophylaxis.

Purpose of the Study:

  • To systematically review randomized controlled trials (RCTs) on fluconazole prophylaxis.
  • To estimate the risk of colonization and infection with fluconazole-resistant fungal strains.

Main Methods:

  • Systematic review of randomized controlled trials.
  • Searched Medline, EMBASE, Cochrane Collaboration database, and internal files.
  • Focused on trials assessing fluconazole's effect on fluconazole-resistant strain incidence.

Main Results:

  • Fluconazole prophylaxis increased colonization risk with susceptible-dose dependent or resistant yeasts and non-albicans Candida.
  • No significant effect on the risk of invasive disease with resistant fungi was observed.
  • Sample size limited assessment of breakthrough infections with non-albicans Candida.

Conclusions:

  • Randomized trial evidence indicates fluconazole prophylaxis elevates colonization risk with resistant fungi.
  • Prophylaxis did not significantly alter the risk of invasive infections by resistant fungi.
  • The risk of breakthrough infections warrants further investigation in large prospective studies.

More Related Videos

Induction of Petite Colonies in Candida glabrate via Rose Bengal-Mediated Photodynamic Therapy09:06

Induction of Petite Colonies in Candida glabrate via Rose Bengal-Mediated Photodynamic Therapy

Published on: March 29, 2024

Related Concept Videos

Inhibitors of Bacterial DNA Synthesis01:28

Inhibitors of Bacterial DNA Synthesis

Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
Pharmacokinetics: Drug–Food and Drug–Viral Interactions01:26

Pharmacokinetics: Drug–Food and Drug–Viral Interactions

A drug interaction occurs when the concurrent use of another drug, food, or an external substance alters the pharmacological activity of a drug. This interaction can modify the action of the original drug, affecting its effectiveness and safety.Drug–food interactions are significant as they impact drug absorption, metabolism, and excretion. For example, grapefruit juice is a well-known disruptor of drug metabolism. It inhibits the cytochrome P450 3A4 enzyme, crucial for the metabolism of many...