Off-label treatments as potential accelerators in the search for the ideal antifungal treatment of cryptococcosis

Future Microbiol. 2023 Jan:18:127-135. doi: 10.2217/fmb-2022-0122. Epub 2023 Jan 23.

Abstract

Cryptococcosis is an opportunistic mycosis that mainly affects immunosuppressed patients. The treatment is a combination of three antifungal agents: amphotericin B, 5-flucytosine and fluconazole. However, these drugs have many disadvantages, such as high nephrotoxicity, marketing bans in some countries and fungal resistance. One of the solutions to find possible new drugs is pharmacological repositioning. This work presents repositioned drugs as an alternative for new antifungal therapies for cryptococcosis. All the studies here were performed in vitro or in animal models, except for sertraline, which reached phase III in humans. There is still no pharmacological repositioning approval for cryptococcosis in humans, though this review shows the potential of repurposing as a rapid approach to finding new agents to treat cryptococcosis.

Keywords: Cryptococcus; antifungal; cryptococcosis; off-label medication; repositioning drugs.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / pharmacology
  • Animals
  • Antifungal Agents / adverse effects
  • Cryptococcosis* / drug therapy
  • Cryptococcosis* / microbiology
  • Cryptococcus neoformans*
  • Fluconazole / pharmacology
  • Fluconazole / therapeutic use
  • Humans
  • Off-Label Use

Substances

  • Antifungal Agents
  • Fluconazole
  • Amphotericin B