Which antifungal class includes drugs that are generally fungicidal?

The class of antifungal agents known as polyenes includes drugs that are primarily considered fungicidal, meaning they kill fungal cells rather than merely inhibiting their growth. This is primarily due to the mechanism of action of polyenes, such as amphotericin B and nystatin. These agents bind to ergosterol, a vital component of the fungal cell membrane, leading to the creation of pores that disrupt membrane integrity. This disruption causes leakage of essential intracellular components, resulting in cell death.

In contrast, other antifungal classes are primarily fungistatic, meaning they inhibit fungal growth rather than directly causing cell death. For instance, azoles work by inhibiting ergosterol synthesis, which impacts fungal cell membrane formation but does not necessarily kill the fungi outright. Echinocandins inhibit the synthesis of beta-glucan, an important part of the fungal cell wall, and have a fungistatic effect. Similarly, allylamines inhibit the enzyme squalene epoxidase, which also contributes to the inhibition of fungal growth rather than killing.

Thus, polyenes are unique within this context, as their mode of action is directly fungicidal, making them particularly effective for treating serious fungal infections where rapid elimination of the pathogen is required