New Formulation of Existing Drugs Proves 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, controlling its spread and potentially preventing it from forming high-fatality infections.

Using a proprietary formulation of topical drugs, terbinafine or clotrimazole, the researchers prevented the growth and spread of the fungus on the skin of a host; the results appear in the latest issue of the journal Antimicrobial agents and chemotherapy.

“It is a very difficult fungus to kill because it is very resilient and opportunistic – which usually takes hold in those whose immune systems are already fighting other threats,” said Mahmoud Ghannoum, who led the research as as director of the Medical Mycology Center at Case Western Reserve School of Medicine and University Hospitals Cleveland Medical Center. “It is promising that we have been able to decolonize – get rid of the fungus from the skin – with a unique formulation of drugs already approved and available.”

The U.S. Centers for Disease Control (CDC) has identified the fungus as 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. The death rate from infection is around 60%, according to a previously published study.

C. auris infections often occur in hospitals – the live fungus undetected, even on the skin of recovering patients, as well as on clothing, bedding and other surfaces. Many of those who are infected are immunocompromised, including patients on antibiotics, which can suppress the presence of good bacteria to help fight the fungus.

It was difficult to identify the fungus and diagnose the infections it causes. But emerging methods of molecular testing capable of definitively detecting the organism are increasingly popular, said Ghannoum.

“Our results could turn out to be a leg of the stool in putting an end to this unique threat,” he said. “Although there are many types of drug resistant bacteria, C. auris is the only one in this regard among the fungi – creating significant challenges for treatment or eradication where it has taken hold. “

In this study, researchers tested the proprietary drug formulation – a novel transdermal blend of 1% terbinafine or 1% clotrimazole created with an emerging method known as “Advanced Penetration Technology” – on the skin of mice. The researchers then seek approval to test the drug mixture on human volunteers.

“As the only fungus resistant to multiple drugs, we still have a lot to learn, especially on the C. auris is in our healthcare facilities, ”said Ghannoum, who is also the Marti D. and Jeffrey S. Davis family master clinician in cancer innovation. . ”