It has emerged quite recently that the use of azole fungicides to prevent fungal infestation of important food crops is strongly implicated in the rapid acquiring of resistance to those antifungal chemicals used.
Bad as this may be for farmers it has deadly consequences for patients who have serious deep, systemic fungal infections such as aspergillosis and need treatment with azole antifungal medication as any acquired resistance puts the efficacy of their treatment at risk.
This is thought to be because widespread agricultural use of azole antifungal drugs increases the risk of a patient inhaling strains of Aspergillus that have already become resistant to one azole and thus are more likely to also be resistant to the azole drugs used by clinicians.
There are relatively few antifungal drugs that can be used to treat aspergillosis and other deep fungal infections so resistance has an important impact on the drugs available to treat these infections. Many of the antifungal drugs currently in use are azole drugs thus there is the potential for a disproportionate impact on the antifungal armoury available to doctors compared with say a bacterial infection where there are more than 20 classes of antibiotic. There are only 4 classes of antifungal drug available for these infections.
Use of azole fungicides for agricultural purposes are extremely widespread throughout the world and there would be a profound impact on food supply if we were to stop using fungicides so it is important for all concerned that alternatives are found quickly. Estimates are that 1 million people die from these types of infection every year and the trend is going up rather than down.
Finding a solution for this quandary is one of the reasons for the launch of the Centre for Medical Mycology at Aberdeen University.