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Resistance to ketoconazole has been observed in a number of clinical fungal isolates, including Candida albicans . Experimentally, resistance usually arises as a result of mutations in the sterol biosynthesis pathway. Defects in the sterol 5-6 desaturase enzyme reduce the toxic effects of azole inhibition of the 14-alpha demethylation step. Multidrug-resistance (MDR) genes can also play a role in reducing cellular levels of the drug. As azole antifungals all act at the same point in the sterol pathway, resistant isolates are normally cross-resistant to all members of the azole family.  
===Name of drug=== *Will be capitalized if it is a trade name (brand name) or uncapitalized if it is a generic name. *Two trade names that are nearly identical (eg Adalat PA and Adalat XL) need not have separate entries unless there is a particular reason for doing so. *Names will be listed alphabetically and broken into an appropriate number of pages (with 200-500??? items per page) Peg-Intron is the correct spelling that you have listed as Pegetron for pegylated interferaon alfa2b made by schering plough and marketed in the US for HCV