Vaseghi Narges, Piramoon Majid, Khojasteh Shaghayegh, Abbasi Kiana, Mohseni Sahar, Javidnia Javad, Naghili Behrooz, Aslani Narges
Department of Pathobiology, Science and Research Branch, Islamic Azad University, Tehran, Iran.
Department of Medicinal Chemistry and Radiopharmacy, School of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran.
Curr Med Mycol. 2022 Jun;8(2):8-15. doi: 10.18502/cmm.8.2.10327.
Invasive candidiasis is a life-threatening condition that kills a large number of immunocompromised patients each year worldwide. We used post-antifungal effect studies to analyze the activities of anidulafungin (AFG), as a clinically crucial antifungal drug, amphotericin B (AMB), and fluconazole (alone and in combinations) against FLC-susceptible and -resistant () isolates obtained from the cancer patients.
We tested the phenomenon of post antifungal effects of FLC, AMB, AFG, and combinations of FLC+AFG, AFG+AMB, and FLC+AMB against 17 isolates obtained from the oral cavity of cancer patients. Isolates that had not been exposed to antifungals, served as a control group. Colony counts were performed at 0, 2, 4, 6, and 24 h after a brief (1 h) exposure to antifungal.
The FLC had no detectable post-antifungal effect independent of antifungal concentration and resembled drug-free FLC (control). Significant variations in the post-antifungal effect were observed when all AMB and AFG were compared to FLC. The combination of AFG and AMB with FLC resulted in effective activity compared to FLC alone. Combination regimens were rated as indifferent in general. Interestingly, low dosages of the AFG displayed increasing fungistatic action as it approached a fungistatic endpoint against isolates (n=17).
Our findings suggested that brief exposure to AFG, in combination with FLC and AMB, at low concentrations of the medicines utilized, could be effective in the evaluation and optimization of new dosage regimens to manage candidiasis. However, future studies will determine the clinical utility of our findings.
侵袭性念珠菌病是一种危及生命的疾病，每年在全球导致大量免疫功能低下的患者死亡。我们采用抗真菌后效应研究，分析了作为临床上关键抗真菌药物的阿尼芬净（AFG）、两性霉素B（AMB）和氟康唑（单独及联合使用）对从癌症患者中分离出的对氟康唑敏感和耐药的（）菌株的活性。
我们测试了氟康唑、两性霉素B、阿尼芬净以及氟康唑+阿尼芬净、阿尼芬净+两性霉素B和氟康唑+两性霉素B联合用药对从癌症患者口腔分离出的17株菌株的抗真菌后效应现象。未接触过抗真菌药物的菌株作为对照组。在短暂（1小时）接触抗真菌药物后0、2、4、6和24小时进行菌落计数。
无论抗真菌药物浓度如何，氟康唑均未检测到抗真菌后效应，与未用药的氟康唑（对照组）相似。将所有两性霉素B和阿尼芬净与氟康唑进行比较时，观察到抗真菌后效应存在显著差异。与单独使用氟康唑相比，阿尼芬净和两性霉素B与氟康唑联合使用具有有效的活性。联合用药方案总体上被评为无差异。有趣的是，低剂量的阿尼芬净在接近对（n = 17）菌株的抑菌终点时，其抑菌作用增强。
我们的研究结果表明，在使用的低浓度药物中，短暂接触阿尼芬净并与氟康唑和两性霉素B联合使用，可能有效地评估和优化治疗念珠菌病的新给药方案。然而，未来的研究将确定我们研究结果的临床实用性。
