Intra-Abdominal Candidiasis and a Novel Echinocandin

Segment Description: Minh-Hong Nguyen, MD, professor of medicine at the University of Pittsburgh, discusses rezafungin as a potential treatment option for intra-abdominal candidiasis.

Interview transcript (modified slightly for readability):

Dr. Nguyen: "Intra-abdominal candidiasis is a disease entity that is associated with very high mortality. Data from our center show that, despite very aggressive management including antibiotics and also surgical debridement, the failure rate is upward of 25 to 30%. The amount of people who were treated with an echinocandin, which is considered as a gold standard therapy in 2010 and beyond, we still see emergence of echinocandin resistance. There is a need to understand the reason why patients fail echinocandin therapy and to see whether there are other agents out there that may fill the gap.

The purpose of my research is to look at the pharmacokinetics within the deep tissue side to see whether we can measure the levels and try to understand why patients fail therapy. Second is to evaluate a new agent that is currently being investigated to be introduced to clinical practice, which is rezafungin. Rezafungin has a major advantage over the current echinocandins because it has excellent pharmacokinetics and pharmacodynamics. The achievable serum level of rezafungin is much higher than micafungin and also it has a very long half-life, which allows us not to have to give that frequent of a dose since all the echinocandins are with the IV formulation."

The study, “Rezafungin Is More Effective Than Micafungin in Treating of FKS-Mutant Candida glabrata Intra-abdominal Candidiasis,” was presented in an oral session on Monday, April 15, 2019, at ECCMID 2019 in Amsterdam, the Netherlands.