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The in vitro activity of iron chelator deferiprone against Candida (Candidozyma) auris in combination with antifungal agents

Summary

Researchers studied how an iron-chelating medication called deferiprone could improve the effectiveness of antifungal drugs against Candida auris, a dangerous drug-resistant fungus. They tested deferiprone combined with several common antifungal medications on different strains of the fungus from around the world. They found that deferiprone worked best when combined with echinocandin drugs, especially against certain regional variants of the fungus, potentially offering a new therapeutic approach for these difficult-to-treat infections.

Background

Candida auris is a highly resistant pathogen with limited susceptibility to conventional antifungal agents. Iron restriction is a promising antimicrobial strategy that can enhance the efficacy of various antimicrobial agents. This study evaluates the potential of iron chelation as a novel therapeutic approach against C. auris.

Objective

To evaluate the in vitro activity of deferiprone, a clinically approved iron-chelating agent, in combination with echinocandins, amphotericin B, and fluconazole against C. auris strains from the four major clades, including echinocandin-resistant isolates.

Results

Synergistic interactions were most frequently observed with echinocandins, particularly at 48 hours, with 22 synergistic combinations observed. Clade II isolates demonstrated unique synergistic interactions with amphotericin B rather than echinocandins. Fluconazole generally showed additive or indifferent interactions with deferiprone across all clades.

Conclusion

Iron chelation with deferiprone may potentiate the antifungal activity of echinocandins against C. auris in a clade- and isolate-specific manner. These findings suggest that iron restriction could be a promising therapeutic strategy, although further in vivo studies are needed to determine clinical efficacy.
  • Published in:Medical Mycology,
  • Study Type:In vitro Experimental Study,
  • Source: PMID: 41388910, DOI: 10.1093/mmy/myaf116
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