Efficacy of Rezafungin on Candida albicans Endophthalmitis in a Rabbit Model

Summary

Researchers tested a new antifungal drug called rezafungin against a serious eye infection caused by Candida fungus in rabbits. Rezafungin performed much better than two other commonly used antifungal drugs, completely eliminating the fungus from the eye while preventing infection-related damage. The drug’s ability to be given weekly instead of daily makes it more practical for treating patients with severe fungal eye infections.

Background

Fungal endophthalmitis is a severe intraocular infection that can cause permanent vision loss if not treated promptly. Candida albicans accounts for 60-65% of fungal endophthalmitis cases. Current antifungal treatments have limited efficacy due to poor ocular penetration.

Objective

To evaluate the efficacy of rezafungin, a novel echinocandin with extended half-life, compared to micafungin and voriconazole in a hematogenous C. albicans endophthalmitis rabbit model.

Results

Rezafungin-treated rabbits showed no detectable CFUs in aqueous humor, vitreous humor, or choroid-retina, compared to positive results in micafungin and voriconazole groups. Rezafungin demonstrated the lowest kidney fungal burden (average log CFUs/g <0.5) and prevented eye lesion formation (severity score 0±0) versus micafungin (1.9±1.4) and voriconazole (2.5±1.8).

Conclusion

Rezafungin demonstrated superior efficacy compared to voriconazole and micafungin in reducing fungal burden in ocular tissues and preventing endophthalmitis-related lesions in the rabbit model. The extended half-life allowing weekly dosing and enhanced tissue distribution make rezafungin a promising candidate for further clinical investigation of fungal endophthalmitis treatment.
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