Antifungal drugs can be grouped into four major classes based on their mechanism of action: (1) alteration of membrane function (polyenes - amphotericin B), (2) inhibition of nucleic acid synthesis (flucytosine), (3) inhibition of ergosterol synthesis(azoles and allylamines), and (4) inhibition of glucan synthesis (echinocandins - e.g. caspofungin). Mechanisms and prevalence of antifungal resistance have been studied extensively in clinical isolates of Candida from human patients with invasive infections, and, to a lesser extent, in human and veterinary isolates of Aspergillus and Cryptococcus spp. By contrast, little is known about resistance to antifungal drugs among other important fungal pathogens including Coccidioides spp. and Histoplasma capsulatum.
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