Recent advances and future perspectives in the pharmacological treatment of Candida auris infections

Expert Rev Clin Pharmacol. 2021 Oct;14(10):1205-1220. doi: 10.1080/17512433.2021.1949285. Epub 2021 Jul 15.

Abstract

Introduction: Candida auris is responsible for hospital outbreaks worldwide. Some C. auris isolates may show concomitant resistance to azoles, echinocandins, and polyenes, thereby possibly leaving clinicians with few therapeutic options.

Areas covered: Antifungal agents both in early and in late phases of clinical development showing anti-C. auris activity.

Expert opinion: The research on antifungal agents active against C. auris has made important steps forward in recent years: (i) the development of drugs with novel mechanisms of action, such as ibrexafungerp and fosmanogepix, could provide a valid option against C. auris strains resistant to one or more older antifungals, including pan-resistant strains; (ii) rezafungin could allow once weekly administration of an active drug in the case of echinocandin-susceptible isolates, providing an effective outpatient treatment, while at the same time relieving selective pressure on novel classes; (iii) the development of oral formulations could allow step-down therapy and/or early discharge, or even to avoid hospitalization in mild or noninvasive diseases; (iv) according to available data, these novel agents show a good safety profile and a low potential for drug-drug interactions.

Keywords: Candida auris; VT-1598; echinocandins; encochleated amphotericin b; fosmanogepix; ibrexafungerp; rezafungin.

Publication types

  • Review

MeSH terms

  • Animals
  • Antifungal Agents / adverse effects
  • Antifungal Agents / pharmacology*
  • Candidiasis, Invasive / drug therapy*
  • Candidiasis, Invasive / epidemiology
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Disease Outbreaks
  • Drug Development
  • Drug Interactions
  • Drug Resistance, Fungal
  • Humans

Substances

  • Antifungal Agents

Supplementary concepts

  • Candida auris infection