Efficacy of Voriconazole, Isavuconazole, Fluconazole, and Anidulafungin in the Treatment of Emerging Candida auris Using an Immunocompromised Murine Model of Disseminated Candidiasis

Antimicrob Agents Chemother. 2021 Aug 17;65(9):e0054921. doi: 10.1128/AAC.00549-21. Epub 2021 Aug 17.

Abstract

Antifungal activity of anidulafungin, voriconazole, isavuconazole, and fluconazole in the treatment of Candida auris was determined in vitro and in vivo. MICs for anidulafungin, voriconazole, isavuconazole, fluconazole, and amphotericin B were 0.5, 1, >64, 0.25, and 4 μg/ml, respectively. Significant in vivo efficacy was observed in the anidulafungin- and voriconazole-treated groups in survival and reduction in kidney tissue fungal burden compared to that in the untreated group (P values of <0.001 and 0.044, respectively). Our data showed that anidulafungin and voriconazole had comparable efficacies against C. auris, whereas isavuconazole did not show significant in vivo activity.

Keywords: Candida auris; anidulafungin; disseminated candidiasis; fluconazole; in vitro; in vivo; isavuconazole; multidrug resistance; murine model; voriconazole.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anidulafungin
  • Animals
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Candida
  • Candidiasis* / drug therapy
  • Disease Models, Animal
  • Fluconazole* / pharmacology
  • Fluconazole* / therapeutic use
  • Mice
  • Microbial Sensitivity Tests
  • Nitriles
  • Pyridines
  • Triazoles
  • Voriconazole / pharmacology
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Nitriles
  • Pyridines
  • Triazoles
  • isavuconazole
  • Fluconazole
  • Anidulafungin
  • Voriconazole