Authors: Shujuan Sun, Shandong Provincial Qianfoshan Hospital, China
Take a look behind the scenes of a recent Future Microbiology review, entitled ‘Anti-Candida activity of existing antibiotics and their derivatives when used alone or in combination with antifungals’ as we ask the authors about Candida infections, the potential repurposing of existing antibiotics as antifungals and the future of this field.
What inspired you to write this piece?
Through searching, we found that a large number of reports have studied the potential anti-Candida activity of antibiotics and their derivatives, which may helpfully provide novel insights for overcoming Candida resistance and discovering new antifungals.
Why are new therapeutic strategies needed for Candida infections?
Because, the incidence of Candida infection is gradually increasing. Besides, growing fungal resistance limits the favorable therapeutic efficacies of conventional antifungals, ultimately making the treatment of Candida infection disease more intractable. Therefore, new therapeutic strategies for Candida infection are warranted.
Why are antibiotics and their derivatives being considered as anti-Candida therapy?
Because many in vitro and in vivo studies have confirmed antifungal activity of antibiotics and their derivatives against Candida spp.. Besides, when patients have fungal–bacterial mixed infections, there is an opportunity for combination therapy in the clinic.
What antifungal activities and mechanisms have been established in antibiotics?
Tetracyclines, quinolones, aminoglycosides, polypeptides and β-lactam antibiotics displayed potential anti-Candida activity, some of them could significantly decrease the minimum inhibitory concentration of flucanazole, such as minocycline, doxycycline and gentamicin. In addition, the antifungal mechanisms mainly include the inhibition of drug efflux, disruption of ionic homeostasis as well as regulation of virulence-related genes.
Are there limitations to this antibiotic crossover for fungal treatment?
This review focuses on providing insights for the future treatment of candidiasis and the development of compound preparation, which have not yet been used for clinical treatment.
What are your predictions for next 10–15 years in this field? What do you hope to see?
We predict that existing antibiotics or their derivatives, used alone or in combination with existing antifungals, may be a novel direction in developing new antifungals and for the treatment of Candida-related infections in the future. We hope to find a more effective combination and apply it to the clinical treatment of Candida. And based on the studies of mechanism, compound preparations were developed by researchers.
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