New formulations of existing drugs are proving to be highly effective against drug-resistant fungi

A team of researchers at Case Western Reserve University have discovered a formulation of existing drugs that can significantly reduce the presence of the fungus Candida auris ((C. auris) on the skin, controls its spread and possibly prevents it from forming high-mortality infections.

By using a proprietary formulation of the topical drugs terbinafine or clotrimazole, the researchers prevented the fungus from growing and spreading on a host's skin. The results appear in the latest issue of the journal Antimicrobials and chemotherapy.

"It is very difficult to kill a fungus because it is very resistant and opportunistic – it generally attacks those whose immune systems are already battling other threats," said Mahmoud Ghannoum, who is the research director of the Center for Medical Mycology on the case directed the Western Reserve School of Medicine and University Hospitals Cleveland Medical Center. "It is promising that we have been able to decolonize and remove the fungus from the skin with a unique formulation of drugs that have already been approved and are available."

The United States Centers for Disease Control (CDC) has determined that the fungus poses a serious public health threat due to its resistance to treatment with existing drugs. The fungus was first found in Japan in 2009 and has since been detected in India, the United States, and other countries. According to previously published research, the death rate from infection is around 60%.

C. auris Infections are common in hospitals – with the fungus living undetected, even on the skin of recovering patients, as well as on clothing, bedding, and other surfaces. Many who become infected are immunocompromised, including those on antibiotics, which can suppress the presence of good bacteria to fight the fungus.

It was difficult to identify the fungus and diagnose the infections it caused. But emerging molecular testing methods that can definitely detect the organism are becoming more widespread, Ghannoum said.

"Our results could prove to be a leg of the chair in stopping this unique threat," he said. "Although there are many types of bacteria that are resistant to drugs, C. auris stands alone among fungi in this regard, creating significant challenges to treat or eradicate where they have prevailed. "

In this study, researchers tested the proprietary formulation of drugs – a novel transdermal blend of 1% terbinafine or 1% clotrimazole made using a new method called "Advanced Penetration Technology" – on the skin of mice. The researchers next apply for permission to test the mixture of drugs on human volunteers.

“As the only fungus that is resistant to multiple drugs, we still have a lot to learn, especially about how it spreads C. auris is in our healthcare system, ”said Ghannoum, who is also the Marti D. and Jeffrey S. Davis Family Master Clinician in Cancer Innovation. "We are encouraged that our results are part of the puzzle in solving this serious health threat around the world."

Source: Case Western Reserve University

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