Conclusions and Future Directions
There are a variety of systemic and topical antifungals available for use in veterinary medicine, and acquisition of antifungal resistance can occur under prolonged therapy or may be associated with resistance selection to fungicides in the environment.
There are many similar characteristics between the use of antifungals in humans and animals; however, many unanswered questions remain, including optimal dosage regimens that maximize clinical outcomes while avoiding toxicities. In addition, the true epidemiology of antifungal resistance in different animal species remains unknown, and treatment options for invasive infections caused by resistant fungi are limited.Although amphotericin B and the echinocandins are useful agents for the treatment of numerous invasive mycoses, these agents are only available for intravenous administration and cannot be administered orally for the treatment of invasive fungal infections. In addition, amphotericin B is associated with significant adverse effects, including nephrotoxicity. As in humans, the triazoles are the main antifungals that are used to treat invasive mycoses in animals, as they can be administered orally for the long periods that are often required to treat these infections, and many veterinarians have experience using the members of this class. In addition, terbinafine is used in combination for difficult-to-treat infections.
Acknowledgement The work of Seyedmojtaba Seyedmousavi was supported by the Intramural Research Program of the NIH, NIAID.