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In vitro combination of voriconazole and miltefosine against clinically relevant molds

S Imbert1, M Palous1, I Meyer1

  • 1AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France.

Antimicrobial Agents and Chemotherapy
|September 10, 2014
PubMed

Insights

Voriconazole combined with miltefosine showed synergistic antifungal activity against some molds, particularly at a 50% inhibition threshold. This combination may offer new therapeutic options for invasive fungal infections in immunocompromised patients.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive filamentous fungal infections pose a significant risk to immunocompromised individuals.
  • Antifungal resistance necessitates exploring novel combination therapies.

Purpose of the Study:

  • To evaluate the in vitro synergistic potential of voriconazole and miltefosine against clinically relevant mold isolates.
  • To assess antifungal interactions against both azole-susceptible and -resistant Aspergillus species.

Main Methods:

  • Tested the combination of voriconazole and miltefosine against 33 mold isolates.
  • Assessed drug interactions using complete inhibition and 50% inhibition endpoints.

Main Results:

  • Interactions were predominantly indifferent (32/33 isolates) when using complete inhibition as the endpoint.
  • Synergistic interactions were observed for 14/33 isolates using a 50% inhibition endpoint.
  • No antagonistic effects were detected between the two drugs.

Conclusions:

  • The combination of voriconazole and miltefosine demonstrates potential for synergistic activity against certain molds, especially at a reduced inhibition threshold.
  • This combination warrants further investigation as a potential treatment strategy for invasive fungal infections.

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