Which antifungal inhibits ergosterol synthesis?

Fluconazole is an antifungal medication that works by inhibiting the synthesis of ergosterol, a vital component of fungal cell membranes. Ergosterol is analogous to cholesterol in human cells but is crucial for maintaining the integrity and fluidity of fungal cell membranes. By blocking the enzyme lanosterol 14-alpha-demethylase, which is involved in the conversion of lanosterol to ergosterol, fluconazole disrupts the membrane structure, leading to cell death or inhibited growth of the fungi.

This mechanism is particularly effective against various systemic and superficial fungal infections, making fluconazole a cornerstone in antifungal therapy. Other antifungals mentioned, such as caspofungin and micafungin, are echinocandins that inhibit the synthesis of β-glucan in the fungal cell wall, and nystatin acts by binding to ergosterol but does not inhibit its synthesis; instead, it disrupts the membrane after binding. Therefore, fluconazole is specifically recognized for its role in inhibiting ergosterol synthesis directly.