Clinical implications of antifungal drug susceptibility testing of dermatophytes

Abstract

Dear Editor, We read with interest the editorial by Dogra et al. titled “Antifungal Drug Susceptibility Testing of Dermatophytes: Laboratory Findings to Clinical Implications” and congratulate the authors for an explicit review on the methodology of antifungal susceptibility testing (AFST) in dermatophytes and problems thereof.[1] We reiterate that in routine microbiology laboratories; the complexity of susceptibility testing procedure in dermatophytes hampers the determination of actual burden of antifungal resistance. Further, as the authors point out, the lack of epidemiological cutoffs (ECV) and clinical break points (CBP) hinders clinical application of AFST data on dermatophytes. We agree with the authors that as with many other pathogenic molds, in dermatophytes too the availability of clinical outcome for determining the CBPs is by and large lacking. Nonetheless, some significant papers on outcome data on dermatophytoses including individual reports, case series and clinical trials are available that will benefit the readers interested in dermatohytoses research, specifically pertaining to AFST and its clinical implications, and are summarized below.