An example of a condition they are sometimes used for is candida vulvovaginitis which is treated with intravaginal Clotrimazole[4] This is sometimes indicated when there's a fungal infection on the skin.

The polyene antimycotics bind with sterols in the fungal cell membrane, principally ergosterol.

However, at therapeutic doses, some amphotericin B may bind to animal membrane cholesterol, increasing the risk of human toxicity.

Therefore, further reduction of the hydrophobic chain may result in it binding to cholesterol, making it toxic to animals.

For example, the azole antifungals such as ketoconazole or itraconazole can be both substrates and inhibitors of the P-glycoprotein, which (among other functions) excretes toxins and drugs into the intestines.

[34] Azole antifungals are also both substrates and inhibitors of the cytochrome P450 family CYP3A4,[34] causing increased concentration when administering, for example, calcium channel blockers, immunosuppressants, chemotherapeutic drugs, benzodiazepines, tricyclic antidepressants, macrolides and SSRIs.

[35] Before oral antifungal therapies are used to treat nail disease, a confirmation of the fungal infection should be made.

[36] Approximately half of suspected cases of fungal infection in nails have a non-fungal cause.

They inhibit the enzyme 14-alpha-sterol demethylase, a microsomal CYP, which is required for the biosynthesis of ergosterol for the cytoplasmic membrane.

This leads to the accumulation of 14-alpha-methylsterols resulting in impairment of function of certain membrane-bound enzymes and disruption of close packing of acyl chains of phospholipids, thus inhibiting growth of the fungi.

[1][38][39] The emergence of Candida auris as a potential human pathogen that sometimes exhibits multi-class antifungal drug resistance is concerning and has been associated with several outbreaks globally.