A review of the current anti-Cryptococcus antifungals and emerging treatment strategies

Abstract

Our knowledge of Cryptococcus neoformans and cryptococcal disease spans many years. Yet, despite numerous clinical studies and revisions to treatment protocols, the burden of cryptococcal disease remains alarmingly high, more so in endemic regions like Africa. Thus, the inclusion of this organism in the World Health Organization’s (WHO) Fungal Priority Pathogens List (FPPL) in part underscores the unmet need to respond to cryptococcal infections and antifungal resistance adequately. To this end, this contribution interrogates the available literature, highlighting emerging treatment strategies to manage infections. Some of these strategies include drug repurposing, immunomodulating therapies and medicinal plants. Although some of the highlighted strategies are still only in the preclinical stages, these studies provide promising evidence of potential alternatives to currently available antifungals. • C. neoformans has emerged as an important fungal pathogen of global importance • Suboptimal therapy and disease-related complications heighten clinical failure risk • We highlight promising approaches that may help to control cryptococcal disease