In Vitro Activity of Isavuconazole and Amphotericin B in Association against Mucorales

Gaia Ortalli; Ester Oliva; Giuliana Lo Cascio; On Behalf Of The Medical Mycology Committee CoSM-Italian Association Of Clinical Microbiologists Amcli; Claudio Farina

doi:10.3390/pathogens12070948

In Vitro Activity of Isavuconazole and Amphotericin B in Association against Mucorales

Pathogens. 2023 Jul 18;12(7):948. doi: 10.3390/pathogens12070948.

Authors

Gaia Ortalli¹, Ester Oliva¹, Giuliana Lo Cascio^{2

3}, On Behalf Of The Medical Mycology Committee CoSM-Italian Association Of Clinical Microbiologists Amcli³, Claudio Farina^{1

3}

Affiliations

¹ Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy.
² Microbiology and Virology Laboratory, Ospedale Guglielmo da Saliceto, Via Taverna 49, 29121 Piacenza, Italy.
³ Medical Mycology Committee (CoSM)-Italian Association of Clinical Microbiologists (AMCLI), Via Carlo Farini 81, 20159 Milano, Italy.

Abstract

Mucormycoses can be treated with the combination of Amphotericin B and Isavuconazole. This study evaluates the effects of these drugs in vitro against 59 strains representing 12 Mucorales. In vitro testing of the two drugs together and alone was performed using the MIC Test strip "Epsilon test synergy-method" (ETSM), which is more standard in clinical practice than microbroth dilution testing. Amphotericin B and Isavuconazole have synergistic/additive effects against L. corymbifera, R. arrhizus and M. circinelloides. Different effects have been shown for other Mucorales. ETSM can help the clinical management of mucormycosis from a practical point of view, due to its feasibility in the laboratory.

Keywords: Amphotericin B; Epsilon test synergy-method; Isavuconazole; Mucormycetes; association.

Grants and funding

This work was supported by a Research Grant Agreement (Number #102261) from Basilea Pharmaceutica International Ltd., Basel, Switzerland.