Eraxis (anidulafungin) / RaQualia - LARVOL DELTA

Safety and efficacy of echinocandin antifungal agents in Candida albicans endophthalmitis. (PubMed, Antimicrob Agents Chemother) - "To evaluate the safety and efficacy of echinocandins (rezafungin, RZF; anidulafungin, AFG) in Candida albicans (C...At 48 h post-infection, rabbits received intravitreal injections of liposomal amphotericin B (L-AmB, 10 μg), voriconazole (VCZ, 50 μg), RZF (35 μg), AFG (35 μg), or saline (control)...In vivo, RZF/AFG reduced clinical and histopathological scores, fungal burden, and TNF-α levels, performing similarly to traditional drugs. RZF and AFG demonstrate potent antifungal activity against C. albicans comparable to conventional drugs, along with significant anti-inflammatory effects and acceptable safety profiles."

Journal • Infectious Disease • Inflammation • Ocular Infections • Ocular Inflammation • Ophthalmology • IL1B • TNFA

Integrated Multi-Omics Analysis Elucidates the Metabolic Basis of Enhanced Echinocandin B Biosynthesis and Guides Targeted Engineering in Aspergillus nidulans. (PubMed, Biotechnol J) - "Echinocandin B (ECB) serves as a crucial precursor for the antifungal drug anidulafungin, yet its production cost remains high due to low fermentation titers...Overexpression of β-oxidation genes (FOX1, FOX2, POT1) increased ECB titers by 25.1%-33.5%. This study delineates the physiological phenotype underlying high ECB production and demonstrates how multi-omics-driven target identification guides effective metabolic engineering for strain enhancement."

Journal • POT1

Evaluation of the Synergistic Activity of Anidulafungin with Isavuconazole, Voriconazole, Posaconazole, and Amphotericin B in Candida auris (Candidozyma auris) Isolates. (PubMed, Infect Drug Resist) - "High resistance rates were observed for fluconazole (72%) and amphotericin B (48%), whereas no isolates were resistant to echinocandins. The predominance of indifferent interactions, with some partial synergy, suggests that combination therapy may not consistently offer a strong synergistic benefit for these isolates. This exploratory study characterizes the in vitro interaction landscape in our isolate collection, providing foundational data to guide future research and inform clinical decisions where treatment options are scarce."

Journal • Infectious Disease

MICAFUNGIN AS ANTIFUNGAL PROPHYLAXIS DURING THE PRE-ENGRAFTMENT PERIOD OF ALLO-HSCT. ANALYSIS OF A 450-PATIENT COHORT (EBMT 2026) - " Table 1: "Baseline characteristics of patients undergoing allo-HSCT receiving micafungin prophylaxis"; n = 450HSCT: Hematopoietic stem cell transplantation; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; MDS: Myelodysplastic síndrome; GVHD: Graft-versus-host disease; MAC: Myeloablative conditioning; RIC: Reduced-intensity conditioning; Cs: Cyclosporine; MTX: Methotrexate; MF: Mycophenolate mofetil; CF post: Post-transplant cyclophosphamide; ATG: Antithymocyte globulin...Two azole-resistant and one anidulafungin-resistant Candida isolates were detected...Among patients with proven or possible IFI (n=34), 26.5% had received corticosteroids during the pre-engraftment period.Antifungal treatments were heterogeneous: liposomal amphotericin B (37.9%), isavuconazole (24.1%), and double-agent combinations (24.1%), mainly in critically ill patients with severe pneumonia or intensive care needs.IFI was the primary cause of death in 3 of 19 patients..."

Clinical • Acute Lymphocytic Leukemia • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Candidiasis • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Mucositis • Myelodysplastic Syndrome • Pneumonia • Respiratory Diseases

MICAFUNGIN AS ANTIFUNGAL PROPHYLAXIS DURING THE PRE-ENGRAFTMENT PERIOD OF ALLO-HSCT. ANALYSIS OF A 450-PATIENT COHORT (EBMT 2026) - " Table 1: "Baseline characteristics of patients undergoing allo-HSCT receiving micafungin prophylaxis"; n = 450HSCT: Hematopoietic stem cell transplantation; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; MDS: Myelodysplastic síndrome; GVHD: Graft-versus-host disease; MAC: Myeloablative conditioning; RIC: Reduced-intensity conditioning; Cs: Cyclosporine; MTX: Methotrexate; MF: Mycophenolate mofetil; CF post: Post-transplant cyclophosphamide; ATG: Antithymocyte globulin...Two azole-resistant and one anidulafungin-resistant Candida isolates were detected...Among patients with proven or possible IFI (n=34), 26.5% had received corticosteroids during the pre-engraftment period.Antifungal treatments were heterogeneous: liposomal amphotericin B (37.9%), isavuconazole (24.1%), and double-agent combinations (24.1%), mainly in critically ill patients with severe pneumonia or intensive care needs.IFI was the primary cause of death in 3 of 19 patients..."

Clinical • Acute Lymphocytic Leukemia • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Candidiasis • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Mucositis • Myelodysplastic Syndrome • Pneumonia • Respiratory Diseases

Prevalence Rates, Species Distribution and Antifungal Susceptibility of Rare Candida and Related Saccharomycotina Yeasts Causing Bloodstream Infections in 28 Medical Centres. (PubMed, Mycoses) - "This study provides valuable insights into the prevalence rates, species distribution and antifungal susceptibility of rare yeasts causing BSIs in tertiary care hospitals. Our findings highlight the need for continuous surveillance, incorporation of new diagnostic and tailored therapeutic strategies to mitigate morbidity and mortality due to invasive infections caused by emerging fungal pathogens."

Journal • Infectious Disease

Invasive Fusariosis Among Patients with Acute Leukemia: A 12-Year Single-Center Experience in a Middle-Income Country. (PubMed, Mycopathologia) - "IF in acute leukemia was associated with extensive dissemination and substantial early mortality. Mortality rates were higher in patients in re-induction therapy and lower in those who received antifungal prophylaxis. The role of combination antifungal therapy requires further investigation."

Journal • Acute Myelogenous Leukemia • Dermatology • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Neutropenia • Oncology

Azole Resistance in Candida parapsilosis From Patients With Burns in Mexico: A Genomic and Phylogenetic Analysis. (PubMed, Mycoses) - "C. parapsilosis sensu stricto was the predominant species isolated, with a notable proportion exhibiting resistance to FLU and VOR. The Y132F variant in the ERG11 gene was present in most sequenced isolates."

Journal • Infectious Disease • Thermal Injury

Hospital Indoor Air as a Reservoir of Opportunistic Filamentous Fungi: Species Diversity and Antifungal Susceptibility. (PubMed, Curr Microbiol) - "In vitro susceptibility to amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and anidulafungin (AFG) was evaluated following CLSI guidelines. The study highlights the importance of routine environmental surveillance and antifungal susceptibility testing in hospital settings. The detection of potentially resistant Aspergillus species in hospital air emphasises the need to enhance ventilation, monitoring, and diagnostic capabilities to mitigate the risks of healthcare-associated fungal infections."

Journal • Infectious Disease

Mutational landscape and molecular bases of echinocandin resistance in Saccharomyces cerevisiae. (PubMed, Genetics) - "This structural framework is integrated with deep-mutational scanning to comprehensively assess the impact of mutations across the three hotspots in the model yeast Saccharomyces cerevisiae. We elucidate several key molecular bases of resistance to the three most widely used echinocandins; anidulafungin, caspofungin and micafungin and provide clues to better understand intrinsic resistance of critical fungal pathogens."

Journal • Infectious Disease

APHP230824: CANDISHORT : A randomized study of a short duration therapy for candidemia (clinicaltrialsregister.eu) - P2/3 | N=399 | Sponsor: Assistance Publique Hopitaux De Paris

New P2/3 trial

Whole genome analysis of azole-resistant Candida tropicalis candidemia outbreak in a haematology ward: a single centre experience. (PubMed, Med Mycol) - "The index patient developed breakthrough candidaemia while receiving fluconazole prophylaxis...Further analysis demonstrated that, among key azole resistance genes, mutations were specifically identified in ERG11. Our findings underscore the critical role of genomic surveillance in uncovering transmission chains of multidrug-resistant fungal pathogens and highlight an urgent need for reinforced infection control measures to contain the spread of this clone."

Journal • Hematological Disorders • Infectious Disease • Septic Shock

In Vitro Activity of Rezafungin Against Planktonic and Biofilm Forms of Candida albicans and Nakaseomyces glabratus Clinical Isolates from Vascular Infections in Poland: A Pilot Study. (PubMed, Pharmaceutics) - " This study tested susceptibility to antimycotics available in Poland (fluconazole, voriconazole, posaconazole, amphotericin B, anidulafungin, caspofungin, and micafungin) using the commercial Micronaut-AM test (Bruker, Bremen, Germany). Furthermore, the high susceptibility of N. glabratus isolates-a species frequently associated with azole resistance-suggests rezafungin may be a valuable addition to the existing antifungal arsenal of multidrug-resistant (MDR) fungal infections in hospital settings. Future research should focus on in vivo models to confirm if these in vitro results translate into accelerated clearance of vascular biofilms."

Journal • Preclinical • Candidiasis • Infectious Disease

Antifungal Susceptibility of Clinical Meyerozyma guillermondii Isolates Obtained Between 1994 and 2014: Original Research and Comparison with Published Data. (PubMed, Pathogens) - "Nine drugs (amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin) were assessed using the MICRONAUT-AT test. The susceptibility to the new drug, manogepix, as well as isavuconazole, clotrimazole and anidulafungin, was determined using the microdilution method recommended by EUCAST...(4) The data obtained in this study are consistent with reports by other authors and indicate that resistance to azoles or 5-fluorocytosine among clinical isolates of Meyerozyma guilliermondii should be considered. The low MIC values of manogepix suggest the potentially good efficacy of this drug against Meyerozyma guilliermondii species."

Journal • Infectious Disease

Effectiveness and Safety of Empirical Antifungal Strategies in Critically Ill, Non-Neutropenic Patients: A Multi-Center Observational Study. (PubMed, Infect Drug Resist) - "Mortality was significantly lower in the group receiving fluconazole (63.16%) compared to those receiving caspofungin (76.80%), liposomal amphotericin B (75%), and anidulafungin (84.83%) (p = 0.028). However, with a confirmed fungal infection rate of only 7.41%, these findings suggest that current patient selection for EAFT is suboptimal. The high overall mortality, coupled with the low infection confirmation rate, underscores the need for improved risk stratification tools to ensure the judicious use of antifungals in this critically ill population."

Journal • Observational data • Critical care • Infectious Disease

A Calcineurin Inhibitor as an Enhancer of Candida Susceptibility to Anidulafungin. (PubMed, ACS Omega) - "Hence, the addition of tacrolimus may enhance susceptibility to anidulafungin, as suggested by checkerboard and time-kill assays conducted against C. parapsilosis, including isolates harboring mutations in FKS1. These promising findings are a starting point for future studies on the antifungal properties of tacrolimus and related compounds."

Journal • Candidiasis

Time to re-evaluate combination antifungal therapy for invasive aspergillosis and other invasive mycoses. (PubMed, Lancet Infect Dis) - "A previous randomised controlled trial of combination therapy with voriconazole plus anidulafungin versus voriconazole alone showed that the combination was safe and associated with a clinically significant reduction in all-cause mortality that, however, failed narrowly to meet conventional levels of significance. In this Personal View, we argue against a binary, negative interpretation of these results, and that the totality of the laboratory and clinical evidence favours a triazole-echinocandin combination for the treatment of immunocompromised patients with proven or probable invasive aspergillosis. Renewed efforts are needed to optimise and evaluate other combination approaches for aspergillosis and other life-threatening invasive fungal diseases as a means by which to mitigate antifungal resistance, maximise and prolong the utility of old and new agents, and drive down mortality."

Journal • Review • Dermatology • Infectious Disease • Pulmonary Disease • Respiratory Diseases

In vitro activity of eight antifungal drugs against clinical and hospital isolates of Candida parapsilosis complex; a multicenter study, 2023-2024. (PubMed, BMC Infect Dis) - "Despite the absence of detectable ERG11 or FKS1 mutations, reduced susceptibility to azoles and echinocandins was observed, primarily among clinical isolates. Environmental and healthcare worker isolates showed lower MIC values, suggesting minimal antifungal selection pressure outside patient care environments. These findings point to emerging antifungal resistance in C. parapsilosis clinical isolates in Iran and emphasize the importance of ongoing surveillance and molecular monitoring to inform therapeutic and infection control strategies. However more studies are required to correlate these findings with clinical outcomes."

Clinical • Journal • Preclinical • Critical care • Infectious Disease

Antifungal susceptibility profiles of candidemia isolates on the east coast of Peninsular Malaysia and reliability of Etest compared to Sensititre YeastOne. (PubMed, Microbiol Spectr) - "Etest demonstrated an inconsistent agreement with SYO, particularly for fluconazole and anidulafungin, with high major and very major error rates. Findings underscore the value of reliable susceptibility testing, demonstrating that the widely used Etest method may misclassify resistance status, potentially impacting treatment choices. These insights inform stewardship efforts and clinical management in resource-constrained settings."

Journal

Candidozyma auris: Identification, Antifungal Susceptibility and, Caspofungin-Induced Paradoxical Growth. (PubMed, Indian J Med Microbiol) - "In our study, it was observed that CHROMagar™ Candida Plus can be used as a screening method for the identification of C. auris in hospitals without access to MALDI-TOF MS. Incompatibility was detected in antifungal susceptibility testing, and the rates of major error (ME) and very major error (VME) were found to be high. For caspofungin, the high dilution range in the SYO method was determined which also detected the Eagle effect."

Journal

In vitro Susceptibilities to caspofungin of Candida spp. isolated from the Polyvalent Intensive Care Unit of Fattouma Bourguiba University Hospital: First report of resistant mutants in Tunisia. (PubMed, J Mycol Med) - "To prevent the rise of resistance to caspofungin, it is necessary to improve mycological surveillance by elaborating breakpoint values adapted to the local fungal ecology and to rationalize the prescription of this molecule."

Journal • Preclinical • Candidiasis • Critical care • Infectious Disease

Uncovering actionable trade-offs of antifungal resistance in a yeast pathogen. (PubMed, Mol Syst Biol) - "Cyclosporin A selectively inhibited anidulafungin-resistant strains, while NaCl effectively suppressed the emergence of fluconazole resistance. This study highlights the widespread occurrence of fitness costs associated with antifungal resistance and emphasizes their potential as a novel therapeutic strategy against this growing threat."

Journal

Identification of claramine and anidulafungin as entry inhibitors of Crimean-Congo hemorrhagic fever virus. (PubMed, Antiviral Res) - "Moreover, they inhibited infection of replication-competent Hazara virus. Therefore, the assays developed in this study were successful in identifying CCHFV entry inhibitors that target membrane fusion."

Journal • Hematological Disorders • Infectious Disease

First case of a human Candida berthetii systemic infection in a preterm infant: a case report. (PubMed, ASM Case Rep) - "Antifungal susceptibility testing, performed using the the European Committee on Antimicrobial Susceptibility Testing (EUCAST) microbroth dilution method, revealed high minimal inhibitory concentrations (MICs) to fluconazole and anidulafungin but low MICs for amphotericin B. Despite switching to liposomal amphotericin B, the infant progressed to multiple organ dysfunction and died. This case broadens the current understanding of rare yeast pathogens and highlights the critical need for improved diagnostic tools to accurately detect and identify uncommon Candida species. Clinicians should remain vigilant to the emergence of rare yeast pathogens causing fungemia, especially among immunosuppressed hosts undergoing invasive medical procedures and prolonged exposure to broad-spectrum antimicrobials."

Journal • Critical care • Infectious Disease

MARIO: A Phase 3, Randomized, Double-blind Study for Patients With Invasive Candidiasis Treated With IV Echinocandin Followed by Either Oral Ibrexafungerp or Oral Fluconazole (clinicaltrials.gov) - P3 | N=68 | Terminated | Sponsor: Scynexis, Inc. | Trial completion date: Feb 2027 ➔ Dec 2025 | Active, not recruiting ➔ Terminated | Trial primary completion date: Dec 2026 ➔ Nov 2025; Termination is not related to safety or efficacy concerns for Ibrexafungerp. GSK's decision is to focus efforts and resources on commercialization of Ibrexafungerp for the already approved VVC and rVVC indications.

Trial completion date • Trial primary completion date • Trial termination • Candidiasis