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Amphotericin B and 5-fluorocytosine penetration into blood and fibrin clots

E Rubinstein

    Chemotherapy
    |January 1, 1979
    PubMed

    Insights

    Amphotericin B showed fungicidal effects in fibrin clots but not blood clots. 5-fluorocytosine (5-FC) was ineffective against fungi in both clot types, potentially explaining treatment failures in fungal endocarditis.

    Area of Science:

    • Mycology
    • Pharmacology
    • Infectious Diseases

    Background:

    • Fungal endocarditis is a serious infection often requiring prolonged treatment.
    • Antifungal medications like amphotericin B and 5-fluorocytosine (5-FC) are used, but treatment outcomes can vary.
    • The physical properties of blood and fibrin clots may influence drug efficacy.

    Purpose of the Study:

    • To investigate the fungicidal activity of amphotericin B and 5-FC against fungi within blood and fibrin clots.
    • To determine if clot composition affects antifungal drug effectiveness.
    • To elucidate potential reasons for treatment failures in fungal endocarditis.

    Main Methods:

    • In vitro study assessing the fungicidal effects of amphotericin B and 5-FC.
    • Fungi were incorporated into both artificial blood clots and fibrin clots.
    • Efficacy was evaluated based on fungal eradication within the clot matrices.

    Main Results:

    • Amphotericin B demonstrated fungicidal activity in fibrin clots but was ineffective in blood clots.
    • 5-fluorocytosine (5-FC) showed no significant fungicidal effect in either blood or fibrin clots.
    • The combination of amphotericin B and 5-FC was also ineffective against fungi in blood clots.

    Conclusions:

    • The poor penetration of amphotericin B into blood clots may contribute to treatment failures in fungal endocarditis.
    • Fibrin clots appear more susceptible to amphotericin B treatment than blood clots.
    • Further research is needed to develop strategies to overcome drug resistance in clot-associated fungal infections.

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