Rising Drug-Resistant Fungal Infections Tied to Antifungal Overuse

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A report from the US Centers for Disease Control and Prevention (CDC) suggests that using antifungal creams and combinations with corticosteroids may fuel the rise of severe fungal infections affecting the skin, scalp, and nails. Initially detected in Southeast Asia, these infections have spread globally, including to the United States, with cases reported in at least 11 states.

To understand the issue, CDC researchers analyzed a year's worth of antifungal prescriptions to identify prescribing patterns among clinicians. They found that primary care physicians accounted for most antifungal prescriptions, followed by nurse practitioners, dermatologists, and podiatrists. The top 10 per cent of prescribers, a group of 13,106 practitioners, were responsible for nearly half of all dispensed medications.

However, the study faced limitations as it lacked diagnostic information on the types of fungal infections patients had, making it difficult to assess whether the prescribed medications were appropriate. Concerningly, a significant portion of prescriptions involved a combination treatment called clotrimazole-betamethasone, which has been linked to the emergence of drug-resistant fungal infections.

The researchers highlight the importance of judicious prescribing and patient education to address the issue of emerging drug-resistant fungal infections. They emphasize the need for diagnostic testing to confirm suspected fungal infections before prescribing medication, especially considering the high rate of incorrect diagnoses made solely based on visual examination.

Overall, the study underscores the urgency of addressing the overuse and inappropriate prescribing of antifungal medications to curb the spread of drug-resistant fungal infections and promote more effective treatment practices.