Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species

Jinqing Zhang,1,* Gaolian Li,2,* Jing Hu,3,* Jingwen Tan,4 Heng Zhang,5 Yizheng Zhou5 1Department of Dermatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Gynaecology, Jingzhou Hospital Affiliated to Yangtze U...

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Main Authors: Zhang J, Li G, Hu J, Tan J, Zhang H, Zhou Y
Format: Article
Language:English
Published: Dove Medical Press 2025-02-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/pyrvinium-pamoate-synergizes-with-azoles-in-vitro-and-in-vivo-to-exert-peer-reviewed-fulltext-article-IDR
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author Zhang J
Li G
Hu J
Tan J
Zhang H
Zhou Y
author_facet Zhang J
Li G
Hu J
Tan J
Zhang H
Zhou Y
author_sort Zhang J
collection DOAJ
description Jinqing Zhang,1,* Gaolian Li,2,* Jing Hu,3,* Jingwen Tan,4 Heng Zhang,5 Yizheng Zhou5 1Department of Dermatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Gynaecology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei Province, People’s Republic of China; 3Department of Clinical Medicine, Xiangyang Polytechnic, Xiangyang, Hubei Province, People’s Republic of China; 4Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 5Department of Clinical Laboratory, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yizheng Zhou, Email [email protected]: Treating infections caused by azole-resistant Candida spp. poses a significant challenge. Previous research has indicated that pyrvinium pamoate (PP) has the potential to augment the antifungal efficacy of azole antifungals against filamentous fungi. The objective of this study was to investigate the antifungal properties of PP, both independently and in conjunction with azoles, against Candida auris and other Candida spp.Materials and Methods: A total of 21 clinical Candida spp. strains and five azoles were assessed. The antifungal efficacy of PP, either alone or in combination with azoles, was tested according to the reference method. Galleria mellonella larvae were employed to evaluate the antifungal efficacy of PP and/or azoles in the treatment of C. auris infections in vivo.Results: When used to treat these different fungal isolates in vitro, the single-agent efficacy of PP was relatively poor, with minimum inhibitory concentration values ranging from 2 μg/mL - > 32 μg/mL. However, PP and azoles exhibited synergistic activity against the majority of analyzed C. albicans and C. auris isolates. To extend these results in vivo, G. mellonella was infected with C. auris strain AR385 and both survival and fungal burden were assessed for treated larvae. The inclusion of PP in combination with itraconazole, voriconazole, or posaconazole resulted in varying degrees of improvement in the survival rates of these larvae.Conclusion: Combining PP with azoles represents a promising approach to effectively disrupting the growth of azole-resistant C. auris and other Candida spp. such that it may be a promising anti-Candida therapeutic option.Keywords: Candida auris, pyrvinium pamoate, synergy azoles, Galleria mellonella
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spelling doaj-art-4128a76b4e3a4b9c8d17145cee34d5db2025-02-11T17:30:55ZengDove Medical PressInfection and Drug Resistance1178-69732025-02-01Volume 18783789100005Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida SpeciesZhang JLi GHu JTan JZhang HZhou YJinqing Zhang,1,* Gaolian Li,2,* Jing Hu,3,* Jingwen Tan,4 Heng Zhang,5 Yizheng Zhou5 1Department of Dermatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Gynaecology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei Province, People’s Republic of China; 3Department of Clinical Medicine, Xiangyang Polytechnic, Xiangyang, Hubei Province, People’s Republic of China; 4Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 5Department of Clinical Laboratory, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yizheng Zhou, Email [email protected]: Treating infections caused by azole-resistant Candida spp. poses a significant challenge. Previous research has indicated that pyrvinium pamoate (PP) has the potential to augment the antifungal efficacy of azole antifungals against filamentous fungi. The objective of this study was to investigate the antifungal properties of PP, both independently and in conjunction with azoles, against Candida auris and other Candida spp.Materials and Methods: A total of 21 clinical Candida spp. strains and five azoles were assessed. The antifungal efficacy of PP, either alone or in combination with azoles, was tested according to the reference method. Galleria mellonella larvae were employed to evaluate the antifungal efficacy of PP and/or azoles in the treatment of C. auris infections in vivo.Results: When used to treat these different fungal isolates in vitro, the single-agent efficacy of PP was relatively poor, with minimum inhibitory concentration values ranging from 2 μg/mL - > 32 μg/mL. However, PP and azoles exhibited synergistic activity against the majority of analyzed C. albicans and C. auris isolates. To extend these results in vivo, G. mellonella was infected with C. auris strain AR385 and both survival and fungal burden were assessed for treated larvae. The inclusion of PP in combination with itraconazole, voriconazole, or posaconazole resulted in varying degrees of improvement in the survival rates of these larvae.Conclusion: Combining PP with azoles represents a promising approach to effectively disrupting the growth of azole-resistant C. auris and other Candida spp. such that it may be a promising anti-Candida therapeutic option.Keywords: Candida auris, pyrvinium pamoate, synergy azoles, Galleria mellonellahttps://www.dovepress.com/pyrvinium-pamoate-synergizes-with-azoles-in-vitro-and-in-vivo-to-exert-peer-reviewed-fulltext-article-IDRcandida auris · pyrvinium pamoate · synergy · azoles · galleria mellonella
spellingShingle Zhang J
Li G
Hu J
Tan J
Zhang H
Zhou Y
Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
Infection and Drug Resistance
candida auris · pyrvinium pamoate · synergy · azoles · galleria mellonella
title Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
title_full Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
title_fullStr Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
title_full_unstemmed Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
title_short Pyrvinium Pamoate Synergizes with Azoles in vitro and in vivo to Exert Antifungal Efficacy Against Candida auris and Other Candida Species
title_sort pyrvinium pamoate synergizes with azoles in vitro and in vivo to exert antifungal efficacy against candida auris and other candida species
topic candida auris · pyrvinium pamoate · synergy · azoles · galleria mellonella
url https://www.dovepress.com/pyrvinium-pamoate-synergizes-with-azoles-in-vitro-and-in-vivo-to-exert-peer-reviewed-fulltext-article-IDR
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