Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 2 2023 01 30 290 305 Firoozeh Kermani Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Mojtaba Taghizadeh‐Armaki Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran Seyed Abdollah Hosseini Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Nasrin Amirrajab Department of Laboratory Sciences‚ School of Allied Medical Sciences‚ Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Javad Javidnia Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran Mahmoud Fami Zaghrami Knowledge-Based Darui Daneshgar Zolang Respina Pharmaceutical Company, Sari, Iran Tahereh Shokohi Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran 2022 04 06 2022 08 23 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 antifungal stewardship strategy and therapeutic drug monitoring is warranted.   https://ijph.tums.ac.ir/index.php/ijph/article/view/28337 https://ijph.tums.ac.ir/index.php/ijph/article/download/28337/7854