Innovation Pharmaceuticals Inc (IPIX)

[farrell90]

Resistant Canidida auris is spreading in Las Vegas ,Florida and California

From the CDC:

"Combination antifungal treatment yielded promising results in laboratory testing but has not been evaluated in clinical settings. Investigational drugs have been tried against C. auris and may be considered for patients with echinocandin-resistant "

Brilacidin in combination with other antifungals may prove to be a key medication for Candida auria. Could a clinical trial be coming? Compassionate use?

The situation with panresistant Candida auris sounds desperate.

"Brilacidin converted CAS from a fungistatic into a fungicidal drug, enabling it to overcome both drug resistance and biofilm formation. Brilacidin exerted, to a lesser degree, synergistic effects with VOR in A. fumigatus. Further in vitro testing showed Brilacidin synergized with CAS in C. albicans, C. auris and C. neoformans. In an A. fumigatus immunosuppressed mouse model in invasive pulmonary aspergillosis, Brilacidin plus CAS cleared infection in the lungs by almost 95 percent, compared to ~50 percent when each compound was administered individually."

https://www.biospace.com/article/releases/innovation-pharmaceuticals-announces-publication-

CDC Recommendations for treatment of Candida auris infections

"Consultation with an infectious disease specialist is highly recommended when caring for patients with C. auris infection.

Even after treatment for invasive infections, patients generally remain colonized with C. auris for long periods, and perhaps indefinitely. Therefore, all recommended infection control measures should be followed during and after treatment for C. auris infection.
Adults and children ≥ 2 months of age

Based on the limited data available to date, an echinocandin drug at a dose listed below is recommended initial therapy for treatment of C. auris infections.
Dose information for Adults and Children ≥ 2 months of age
Dose information for Adults and Children ≥ 2 months of age
Echinocandin Drug Adult dosing Pediatric dosing
Anidulafungin loading dose 200 mg IV,
then 100 mg IV daily not approved for use in children
Caspofungin loading dose 70 mg IV,
then 50 mg IV daily loading dose 70mg/m2/day IV, then 50mg/m2/day IV
(based on body surface area)
Micafungin 100 mg IV daily 2mg/kg/day IV with option to increase to 4mg/kg/day IV in children at least 40 kg

Most strains of C. auris found in the United States have been susceptible to echinocandins although reports of echinocandin—or pan-resistant cases are increasing. This organism appears to develop resistance quickly. Patients on antifungal treatment should be carefully monitored for clinical improvement. Follow-up cultures and repeat susceptibility testing should be conducted. Both recurrent and persistent C. auris bloodstream infections have been documented.

Switching to a liposomal amphotericin B (5 mg/kg daily) could be considered if the patient is clinically unresponsive to echinocandin treatment or has persistent fungemia for >5 days.

Data are lacking about the most appropriate therapy for pan-resistant strains. Combination antifungal treatment yielded promising results in laboratory testing but has not been evaluated in clinical settings. Investigational drugs have been tried against C. auris and may be considered for patients with echinocandin-resistant ."

https://www.cdc.gov/fungal/candida-auris/c-auris-treatment.html

GLTA Farrell