micafungin and Mycetoma

Eumycetoma caused by Madurella mycetomatis is treated surgically and with high doses of ketoconazole. Therapeutic responses are poor, and recurrent infections are common. In search of therapeutic alternatives in the treatment of mycetoma, we determined the in vitro susceptibilities of M. mycetomatis isolates against caspofungin, anidulafungin, and micafungin. As a comparator fungus, Aspergillus fumigatus was used. Minimal effective concentrations (MECs) and MICs were assessed and compared to those of ketoconazole. M. mycetomatis isolates were not susceptible to the echinocandins.

Topics: Anidulafungin; Antifungal Agents; Aspergillus fumigatus; Caspofungin; Drug Resistance, Fungal; Echinocandins; Humans; In Vitro Techniques; Lipopeptides; Madurella; Micafungin; Microbial Sensitivity Tests; Mycetoma

We have evaluated the efficacies of micafungin, amphotericin B, and voriconazole, alone and in double and triple combinations, in a murine model of systemic infection by Scedosporium prolificans. Micafungin combined with voriconazole or amphotericin B was the most effective, these being the only treatments able to prolong survival and to reduce the fungal load in the kidneys and brain. Triple combinations of these drugs did not improve the results obtained with double combinations.

Topics: Amphotericin B; Animals; Antifungal Agents; Brain; Disease Models, Animal; Drug Resistance, Fungal; Drug Therapy, Combination; Echinocandins; Humans; Kidney; Lipopeptides; Male; Micafungin; Mice; Microbial Sensitivity Tests; Mycetoma; Pyrimidines; Scedosporium; Treatment Outcome; Triazoles; Voriconazole