The dual role of azoles: lifesaving antifungals and drivers of resistance – a One Health perspective

Nature Communications 2026 Open access

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Authors: Behrad Roohi, Joel D. A. Tyndall, Thomas Svoboda, Sybren de Hoog, P.W. Crous, Brian C. Monk, Birgit Strobl, Annemarie Weißenbacher, Joseph Strauss, Paul E. Verweij, Michaela Lackner
DOI: 10.1038/s41467-026-71762-9
Cited by: 8
References: 248

Abstract

Azole antifungals are essential for controlling fungal diseases in medicine, veterinary care and agriculture. However, extensive cross-sector use has accelerated the emergence of resistant fungal pathogens, threatening human health, food security and ecosystem stability. This Review examines the dual role of azoles as life-saving therapeutics and drivers of antifungal resistance. We outline their development, mechanisms of action and applications across sectors, and highlight environmental and evolutionary pressures shaping resistance. Integrating perspectives from microbiology, agriculture and public health, we argue that coordinated One Health stewardship and sustainable antifungal strategies are urgently needed to preserve the efficacy of these critical compounds.

Fields of Study & Subjects

Antifungal resistance and susceptibility Fungal Infections and Studies Plant-Microbe Interactions and Immunity

Publication details

Journal / source
Nature Communications
Publisher
Springer Science and Business Media LLC
Volume
17
Issue
1
Publication date
18 April 2026
Language
EN