Figure 2. Mechanisms of Resistance with Fluconazole-Resistant Candidiasis

Candida species have adapted several mechanisms of fluconazole resistance, with the most important of these consisting of an alteration in the target enzyme 14 alpha-demethylase (change in binding site or overexpression of the enzyme) or from enhanced drug efflux caused by plasma membrane transporters. The net effect of the efflux pump is to decrease the intracellular concentration of fluconazole and thus reduce the concentration of drug that reaches the active site at the enzyme 14 alpha-demethylase.

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