Key issues concerning fungistatic versus fungicidal drugs

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

    Research output: Contribution to journalArticlepeer-review

    34 Scopus citations

    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 all 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.

    Original languageEnglish (US)
    Pages (from-to)42-50
    Number of pages9
    JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
    Volume16
    Issue number1
    DOIs
    StatePublished - 1997

    ASJC Scopus subject areas

    • Microbiology (medical)
    • Infectious Diseases

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