Problematic mycoses: Rising resistance to terbinafine

Therapy-resistant fungal infections of the nail or skin are on the rise and spreading. The lack of Terbinafine response in particular can be problematic.

Interesting facts about mycosis resistance to therapy:

Where does the resistance come from?

Fungal diseases of the skin and nails are very contagious and spread rapidly. Fungal strains that are resistant to treatment therefore spread just as quickly. There are various reasons why pathogens are immune to certain drugs. This can occur at the molecular genetic level, but can also be due to individual factors in the host, i.e. the patient.

It is therefore important to quickly interrupt the spread of resistant fungi and treat them accordingly. 

Which methods are suitable for diagnosis?

A reliable diagnosis is the be-all and end-all in such cases. Traditional methods like laboratory examinations and staining, as well as molecular identification methods, are still the first step in identifying the fungus. However, newer methods such as genome analysis and PCR procedures can also contribute to a rapid and correct diagnosis. In this way, possible terbinafine resistance can be determined even before the start of treatment.

What to do with terbinafine resistance?

Unfortunately, the fact that a fungus is resistant to terbinafine is becoming increasingly common. This often raises the question of what to do in such cases. According to experts, there are several options:

Take aways for medical practice

More strains of fungi that cause nail or skin infections are showing one or more forms of resistance. As with bacteria, this is a major problem worldwide. It is therefore important to treat these infections adequately and in a targeted manner in order to contain the spread of the immune strains and break the chain of resistance. If there is still immunity to drugs, combination therapies or changing the treatment regimen are possible options.