Wake, RM; Allebone-Salt, PE; John, LLH; Caswall, BA; Govender, NP; Ben-Ami, R; Murray, LW; Logan, C; Harrison, TS; Bicanic, TA
(2024)
Optimizing the Treatment of Invasive Candidiasis-A Case for Combination Therapy.
Open Forum Infect Dis, 11 (6).
ofae072.
ISSN 2328-8957
https://doi.org/10.1093/ofid/ofae072
SGUL Authors: Bicanic, Tihana Wake, Rachel Marie Harrison, Thomas Stephen Allebone-Salt, Phoebe Emily
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Abstract
Invasive candidiasis is a rising global health threat with increasing incidence, persistently high mortality, and diminishing treatment options. Antifungal resistance has rapidly emerged and spread, with multidrug-resistant species deemed an urgent and serious threat. While acknowledging the key role of antifungal stewardship and infection control in curbing spread, we examine the role of antifungal monotherapy in driving resistance and the potential for combination therapy to prevent stress adaptation and emergence of drug resistance. In addition to its role in mitigating resistance, combination treatment may improve drug penetration, expedite fungal clearance, and allow lower, less toxic doses of individual drugs to be used. A growing body of laboratory-based evidence suggests that antifungal combinations can yield synergistic activity against Candida spp., including against frequently multidrug-resistant Candida auris. It is imperative to test these combinations in clinical trials, incorporating resistance end points as a marker of success.
Item Type: | Article | |||||||||||||||
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Additional Information: | © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. | |||||||||||||||
Keywords: | Candida auris, candidiasis, combination, drug resistance, drug therapy | |||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) Academic Structure > REF 2021 user group |
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Journal or Publication Title: | Open Forum Infect Dis | |||||||||||||||
ISSN: | 2328-8957 | |||||||||||||||
Language: | eng | |||||||||||||||
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | |||||||||||||||
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PubMed ID: | 38887482 | |||||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/116476 | |||||||||||||||
Publisher's version: | https://doi.org/10.1093/ofid/ofae072 |
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