Interaction of local anaesthetics with other antifungal agents against pathogenic Aspergillus

International Journal of Antimicrobial Agents
Acacio Gonçalves RodriguesCidalia Pina-Vaz

Abstract

Aspergillus spp. are responsible for an increasing number of fungal infections in immunocompromised and transplant patients. Local anaesthetics (LAs) are growth inhibitors of bacteria and yeasts. Subinhibitory concentrations of the LAs lidocaine and bupivacaine blocked the germination of Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger whilst also showing a positive interaction in vitro with the antifungal activity of amphotericin B, itraconazole and caspofungin and a negative interaction with voriconazole. At higher concentrations, both LAs present fungicidal activity against resting conidia owing to cell membrane lesions. Verapamil, nifedipine and lanthanum produced a similar inhibitory effect on conidia germination. Calcium chloride reverted the inhibitory effect of verapamil and LAs. This study highlights that drug interactions may affect the clinical efficacy of antifungals, either promoting or limiting their action.

Citations

Sep 12, 2008·Current Opinion in Anaesthesiology·Jeffrey L WrightDanja S Groves
Apr 3, 2014·Der Anaesthesist·J Ahrens, A Leffler
Jan 27, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Bibi Marjan Razavi, Bibi Sedigheh Fazly Bazzaz
Nov 19, 2020·Antibiotics·Jong H KimKirkwood M Land

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