Enlisting the Off-Target Effects of HIV Protease Inhibitors in the Fight Against Candida auris

Atazanavir restored itraconazole activity against C. auris both in vitro and in vivo.

With the rising costs of new drug development, repurposed FDA-approved drugs represent a valuable option for keeping up with antibiotic resistance in microorganisms such as Candida auris, an emerging fungal pathogen with limited treatment options.

Focusing on the HIV protease inhibitor (PI) atazanavir as a co-drug with azole antifungals, Elgammal et al. examined the combination's activity against C. auris. Atazanavir alone had no direct in vitro activity against 19 C. auris strains (MIC >128 µg/mL) but showed synergy with fluconazole against 7 of these strains and with itraconazole against all 19 strains. In time-kill assays where atazanavir and itraconazole alone each permitted fungal growth similar to control, atazanavir plus itraconazole …

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