The challenge with drugs to treat fungal infections

The quantity and risk of fungal infections continues to grow worldwide, particularly as global temperatures warm, creating new environments for fungus to thrive, but drugs to treat these new and emerging infections haven't kept the same pace.

The last antifungal drug approval was issued by the FDA in 2000. In 2023, a drug known as olorofim was inching closer to FDA approval, but ultimately the agency rejected it, requesting additional data. 

Right now, there are only three classes of antifungal drugs, which is few in comparison to antibacterial drugs, of which there are dozens, Leah Cowen, PhD, a professor of molecular genetics at the University of Toronto told NBC News.

Since humans share molecular DNA with fungi, a drug that balances protection of the surrounding body while killing the fungal infection is difficult to create, and resistance to any drugs that are developed can also become the result. 

"I'm concerned that many patients will die because our current set of antifungal drugs are limited, and more fungi are resistant to the few antifungal drugs available," Anna Selmecki, PhD, an associate professor of microbiology and immunology at the University of Minnesota Medical School told NBC.

New antifungal drugs take around 25 years on average to develop, so if the makers of olorofim are able to provide the data the FDA is looking for, the drug would be coming on scene at a critical time.

"They are the most similar organism to humans to human cells, which makes them hard to kill and hard to identify because they're similar to our own bodies and therefore drugs that kill fungi kill human cells, potentially," Tom Chiller, MD, CDC's head of mycotic diseases told Becker's during a previous interview. "So we will have to find specific targets for new antifungal drugs."

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