As ergosterol forms a critical part of the fungal cell membrane, fluconazole inhibits the synthesis of ergosterol to increase cellular permeability. įluconazole interacts with 14-demethylase, a cytochrome P-450 enzyme responsible for catalyzing the conversion of lanosterol to ergosterol. Similarly, cryptococcal meningoencephalitis has been reported in immunocompromised patients, which requires aggressive treatment with the induction phase for amphotericin B and flucytosine, followed by fluconazole followed by consolidation and secondary prophylaxis with fluconazole. Fluconazole or other azoles can be used in combination with echinocandins and liposomal amphotericin B. Invasive candidiasis has been reported in patients with severe COVID-19 infection. Recent studies have proven that fluconazole is more effective at treating soft tissue and pulmonary infections than other azole antifungal treatments, mainly with infections caused by coccidioidomycosis. Recently, there has been an increase in fluconazole administration to treat coccidioidomycosis inflicted bone and joint infection, meningitis, pneumonia in immunocompromised patients, and pneumonia as a primary infection in HIV-positive or severely debilitated patients. Non-FDA-approved uses for fluconazole include blastomycosis, histoplasmosis, and coccidioidomycosis. Prophylaxis is also known to decrease candidiasis incidence in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy or radiation therapy. It is an FDA-approved drug to treat vaginal candidiasis, oropharyngeal and esophageal candidiasis, peritonitis, and systemic Candida infections, including candidemia, disseminated candidiasis, pneumonia, and cryptococcal meningitis.
Fluconazole is a member of the triazole family, one of the most widely used antifungal agents.
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