Antifungal Resistance of Clinical Candida albicans Isolates in Iran: A Systematic Review and Meta-Analysis

Abstract

Background: The present systematic review aimed to investigate the drug susceptibility patterns of Iranian clinical Candida albicans isolates to antifungal drugs (azoles, polyenes, and echinocandins). Methods: Six electronic databases including “PubMed,” “Scopus,” “Web of Science,” “IranDoc”, “SID”, and “Magiran” were searched from May 2000 to June 2021. The susceptibility of 6322 C. albicans strains from 19967 patients against 14 antifungal drugs was evaluated according to CLSI method. Results: The pooled prevalence of antifungal resistance ranged from 0% to 26%. The lowest resistance levels among azoles were observed in luliconazole with a frequency of 0% and voriconazole of 3.94%. Conclusion: Due to the emergence of multi-drug resistant C. albicans, rational drug prescription based on the anti-fungal stewardship strategy and therapeutic drug monitoring is warranted.