Lopinavir Aids Azoles in Treating Drug-Resistant Candida auris Infections

Lopinavir augments the activity of the azole class of antifungals against multidrug-resistant C. auris.

Candida auris has caused several outbreaks of invasive infections around the world since it emerged in 2009, with mortality rates of approximately 50% in invasive disease (Emerg Infect Dis 2020; 26:876). Among U.S. C. auris isolates, resistance to fluconazole, amphotericin B, and echinocandins is 90%, 30%, and 5%, respectively. Of the antifungals, azoles are preferred due to their lower cost and oral bioavailability but have little role in treating C. auris because of resistance. In this study, researchers evaluated 1547 drugs for chemosensitization of C. auris to azole antifungals in vitro.

Lopinavir, an older HIV protease inhibitor, greatly sensitized C. auris to azole antifungal drugs, particularly itraconazole. In checkerboard assays, th…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases