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Anidulafungin in combination with amphotericin B against Aspergillus fumigatus

Elisabetta Spreghini1, Fiorenza Orlando, Alfredo Santinelli

  • 1Dipartimento di Scienze Biomediche, Clinica di Malattie Infettive, Università Politecnica delle Marche, Ancona, Italy.

Antimicrobial Agents and Chemotherapy
|July 15, 2009
PubMed

Insights

Anidulafungin and amphotericin B showed similar efficacy against invasive aspergillosis in mice. The combination therapy did not offer superior survival benefits compared to single-drug treatments.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive aspergillosis poses a significant threat, necessitating effective antifungal therapies.
  • Echinocandins like anidulafungin are crucial in treating fungal infections.
  • Amphotericin B remains a cornerstone antifungal agent.

Purpose of the Study:

  • To evaluate the in vitro and in vivo efficacy of anidulafungin, alone and in combination with amphotericin B.
  • To determine the interaction between anidulafungin and amphotericin B against Aspergillus fumigatus.
  • To assess the impact on survival and fungal burden in a murine model of invasive aspergillosis.

Main Methods:

  • In vitro susceptibility testing to determine drug interactions.
  • Murine model of invasive aspergillosis induced by Aspergillus fumigatus.
  • Administration of anidulafungin (1 and 5 mg/kg/day) and amphotericin B (1 mg/kg/day) alone and in combination.
  • Assessment of survival rates and quantification of fungal burden in kidneys.

Main Results:

  • In vitro studies revealed indifferent interaction between anidulafungin and amphotericin B.
  • Both monotherapy with anidulafungin (5 mg/kg/day) and combination therapy prolonged survival in mice.
  • Anidulafungin at 5 mg/kg/day, alone or combined with amphotericin B, significantly reduced kidney fungal burden.
  • The combination therapy did not demonstrate superior efficacy over the most active single agent.

Conclusions:

  • Anidulafungin exhibits antifungal activity against Aspergillus fumigatus in vivo.
  • Combination therapy with anidulafungin and amphotericin B is not superior to monotherapy in this murine model.
  • Further research may explore different dosing or combinations for enhanced outcomes.

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