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Despite their success at targeting fungi, antifungal medications for systemic infections have more toxic side effects than antibiotics for bacteria.
Antibiotics like penicillin come to mind when we think of antimicrobial medications. Penicillin and related antibiotics inhibit peptidoglycan cell wall synthesis, effectively targeting bacterial cells. Because humans (like all eukaryotes) lack peptidoglycan cell walls, these antibiotics are beneficial. It is more difficult to create medications that are effective against eukaryotic cells but are not harmful to human cells.
Despite their vast morphological differences, human, fungi, and protist cells share ribosomes, cytoskeletons, and cell membranes. As a result, developing medications that target protozoans and fungi in the same way that antibiotics target prokaryotes is more difficult.
Fungicides have only a few modes of action. Because fungi have ergosterols (rather than cholesterol) in their cell membranes, some medications may target the various enzymes involved in sterol production. Fungicides like azole and morpholine disrupt the synthesis of membrane sterols. These are widely used in agriculture (fenpropimorph) and in medicine (e.g., miconazole). Some antifungal medications target fungi's chitin cell walls.
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