Case Commentary: Extending Our Therapeutic Range Against Multidrug-resistant

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 2024 Jul 22

PMID 39037274

Authors

Max W Adelman

David R Andes

Affiliations

Soon will be listed here.

Abstract

Deep-seated spp. infections may necessitate extended durations of antifungal therapy. Increasing resistance to first-line antifungals threatens the most common options for long-term treatment. In this issue, Ponta et al. (Antimicrob Agents Chemother 68:e00750-24, 2024, https://doi.org/10.1128/aac.00750-24) present cases in which they used rezafungin, a novel long-acting echinocandin antifungal, for extended durations. While excellent clinical evidence supports the short-term safety of rezafungin, these cases demonstrate that rezafungin may additionally have a role in long-term suppressive therapy for antifungal-resistant spp. infections.

References

Kim E, Lee E, Kwak Y, Yoo H, Choi J, Kim S . Trends in the Epidemiology of Candidemia in Intensive Care Units From 2006 to 2017: Results From the Korean National Healthcare-Associated Infections Surveillance System. Front Med (Lausanne). 2021; 7:606976. PMC: 7773785. DOI: 10.3389/fmed.2020.606976. View

Hoenigl M, Arastehfar A, Arendrup M, Bruggemann R, Carvalho A, Chiller T . Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease. Clin Microbiol Rev. 2024; 37(2):e0007423. PMC: 11237431. DOI: 10.1128/cmr.00074-23. View

Diekema D, Arbefeville S, Boyken L, Kroeger J, Pfaller M . The changing epidemiology of healthcare-associated candidemia over three decades. Diagn Microbiol Infect Dis. 2012; 73(1):45-8. DOI: 10.1016/j.diagmicrobio.2012.02.001. View

Arnold C, Johnson M, Bayer A, Bradley S, Giannitsioti E, Miro J . Candida infective endocarditis: an observational cohort study with a focus on therapy. Antimicrob Agents Chemother. 2015; 59(4):2365-73. PMC: 4356766. DOI: 10.1128/AAC.04867-14. View

Gamaletsou M, Kontoyiannis D, Sipsas N, Moriyama B, Alexander E, Roilides E . Candida osteomyelitis: analysis of 207 pediatric and adult cases (1970-2011). Clin Infect Dis. 2012; 55(10):1338-51. PMC: 3657498. DOI: 10.1093/cid/cis660. View

Chew S, Heath C, Petursson C, Boan P, Robinson J, Italiano C . Antifungal use via outpatient parenteral antimicrobial therapy. Mycoses. 2022; 65(10):946-952. DOI: 10.1111/myc.13513. View

Ahlquist Cleveland A, Farley M, Harrison L, Stein B, Hollick R, Lockhart S . Changes in incidence and antifungal drug resistance in candidemia: results from population-based laboratory surveillance in Atlanta and Baltimore, 2008-2011. Clin Infect Dis. 2012; 55(10):1352-61. PMC: 4698872. DOI: 10.1093/cid/cis697. View

Vallabhaneni S, Cleveland A, Farley M, Harrison L, Schaffner W, Beldavs Z . Epidemiology and Risk Factors for Echinocandin Nonsusceptible Candida glabrata Bloodstream Infections: Data From a Large Multisite Population-Based Candidemia Surveillance Program, 2008-2014. Open Forum Infect Dis. 2015; 2(4):ofv163. PMC: 4677623. DOI: 10.1093/ofid/ofv163. View

Gil-Navarro M, Luque-Marquez R, Baez-Gutierrez N, Alvarez-Marin R, Navarro-Amuedo M, Praena-Segovia J . Antifungal treatment administered in OPAT programs is a safe and effective option in selected patients. Enferm Infecc Microbiol Clin (Engl Ed). 2020; 38(10):479-484. DOI: 10.1016/j.eimc.2020.01.019. View

10.

Jiang C, Dong D, Yu B, Cai G, Wang X, Ji Y . Mechanisms of azole resistance in 52 clinical isolates of Candida tropicalis in China. J Antimicrob Chemother. 2012; 68(4):778-85. DOI: 10.1093/jac/dks481. View

11.

Lockhart S, Iqbal N, Cleveland A, Farley M, Harrison L, Bolden C . Species identification and antifungal susceptibility testing of Candida bloodstream isolates from population-based surveillance studies in two U.S. cities from 2008 to 2011. J Clin Microbiol. 2012; 50(11):3435-42. PMC: 3486211. DOI: 10.1128/JCM.01283-12. View

12.

Kessler S, Lang P, Dal-Pizzol T, Montagner F . Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta-analysis. Clin Oral Investig. 2022; 26(11):6479-6489. PMC: 9514684. DOI: 10.1007/s00784-022-04716-2. View

13.

Sandison T, Ong V, Lee J, Thye D . Safety and Pharmacokinetics of CD101 IV, a Novel Echinocandin, in Healthy Adults. Antimicrob Agents Chemother. 2016; 61(2). PMC: 5278714. DOI: 10.1128/AAC.01627-16. View

14.

Thompson 3rd G, Soriano A, Cornely O, Kullberg B, Kollef M, Vazquez J . Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): a multicentre, double-blind, double-dummy, randomised phase 3 trial. Lancet. 2022; 401(10370):49-59. DOI: 10.1016/S0140-6736(22)02324-8. View

15.

Ponta G, Morena V, Strano M, Molteni C, Pontiggia S, Cavalli E . Safety of rezafungin as a long-term treatment option in two patients with complicated fungal infections: two cases from Lecco Hospital (Italy). Antimicrob Agents Chemother. 2024; 68(8):e0075024. PMC: 11304680. DOI: 10.1128/aac.00750-24. View

16.

Pappas P, Kauffman C, Andes D, Clancy C, Marr K, Ostrosky-Zeichner L . Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015; 62(4):e1-50. PMC: 4725385. DOI: 10.1093/cid/civ933. View

17.

Kordalewska M, Cancino-Prado G, de Almeida Junior J, Brasil Brandao I, Peral R, Colombo A . Novel Non-Hot Spot Modification in Fks1 of Candida auris Confers Echinocandin Resistance. Antimicrob Agents Chemother. 2023; 67(6):e0042323. PMC: 10269051. DOI: 10.1128/aac.00423-23. View

18.

Boland J, Chung H, Robberts F, Wilson W, Steckelberg J, Baddour L . Fungal prosthetic valve endocarditis: Mayo Clinic experience with a clinicopathological analysis. Mycoses. 2010; 54(4):354-60. DOI: 10.1111/j.1439-0507.2010.01884.x. View

19.

Espinel-Ingroff A, Pfaller M, Bustamante B, Canton E, Fothergill A, Fuller J . Multilaboratory study of epidemiological cutoff values for detection of resistance in eight Candida species to fluconazole, posaconazole, and voriconazole. Antimicrob Agents Chemother. 2014; 58(4):2006-12. PMC: 4023759. DOI: 10.1128/AAC.02615-13. View

20.

Sanglard D, Coste A . Activity of Isavuconazole and Other Azoles against Candida Clinical Isolates and Yeast Model Systems with Known Azole Resistance Mechanisms. Antimicrob Agents Chemother. 2015; 60(1):229-38. PMC: 4704203. DOI: 10.1128/AAC.02157-15. View