The significance of fungal infection is often neglected in society. However, fungal infections affect more than a billion people, resulting in approximately 11.5 million life-threatening infections and more than 1.5 million deaths annually.¹  

The antifungals, used to treat fungal infections, are a diverse group of drugs that include inhibitors of membrane and cell wall synthesis, as well as compounds that cause alterations of fungal membranes, effects on microtubules, and inhibition of nucleic acid synthesis. These drugs can be given topically or systemically depending on the disease.² 

There are three main classes of systemic antifungals; polyenes (amphotericin B), imidazoles, and triazoles, and allylamines. Topical antifungals include imidazoles, tolnaftate, terbinafine and the polyenes nystatin and amphotericin.² 

The clinical outcomes for most invasive fungal infections are far from ideal and even non-invasive infections can take months, if not years, to treat. One of the main challenges to current treatment options is the emergence of antifungal drug resistance. Examples of this include azole resistance among non-Candida albicans isolates, azole resistance in Aspergillus fumigatus, and echinocandin resistance in C. glabrata.  

Some fungal species demonstrate resistance to all clinically available antifungals.³ Patients who have infections caused by such species have very few remaining treatment options. 

The treatment of non-invasive fungal infections is limited by poor penetration of topical antifungals. This limitation is particularly