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Investigation of the antifungal activity of panobinostat, tamoxifen, and miltefosine alone and in combination with some conventional antifungal drugs against fluconazole-resistant Candida species

Summary

Researchers tested whether three cancer drugs (panobinostat, tamoxifen, and miltefosine) could enhance the effectiveness of common antifungal medications against drug-resistant yeast infections. When combined with antifungals, some of these cancer drugs showed promise in killing resistant Candida species, though the effectiveness varied depending on which type of yeast was being treated. These findings suggest that combination therapies using already-approved drugs could help treat difficult fungal infections in cancer patients.

Background

The increasing incidence of antifungal-resistant Candida infections, particularly among cancer patients, presents a significant clinical challenge. Current antifungal therapies have limited options due to emerging resistance to azoles and echinocandins, and the need for novel therapeutic strategies is urgent.

Objective

This study aimed to assess the in vitro antifungal efficacy of three anticancer agents—tamoxifen, panobinostat, and miltefosine—both individually and in combination with fluconazole and itraconazole against fluconazole-resistant Candida species.

Results

Panobinostat combined with fluconazole demonstrated full synergistic activity against C. albicans and C. tropicalis but antagonistic effects with C. parapsilosis and C. glabrata. Miltefosine combined with itraconazole and tamoxifen combined with itraconazole both showed synergistic effects against C. albicans, while certain combinations showed antagonistic or indifferent responses depending on the Candida species.

Conclusion

Certain combinations of antifungals and anticancer agents could potentiate antifungal activity against resistant Candida isolates. Precise species-level identification is vital for tailoring effective combination therapies, particularly in immunocompromised individuals, and these findings may facilitate further investigations and clinical trials.
  • Published in:Iran Journal of Microbiology,
  • Study Type:In vitro experimental study,
  • Source: PMID: 41234641, DOI: 10.18502/ijm.v17i5.19894
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