The postantifungal and paradoxical effects of echinocandins against Candida spp

Future Microbiology
Brad MoriyamaThomas J Walsh

Abstract

Echinocandins induce a postantifungal effect and a paradoxical effect. The postantifungal effect is a concentration-dependent process that allows for sustained kill of Candida spp. after relatively brief exposures to a compound. The paradoxical effect is growth that occurs at high echinocandin concentrations above the MIC. Paradoxical growth varies in terms of media, species, strain and type of echinocandin. The study by Shields et al. evaluated the impact of a brief exposure of caspofungin on paradoxical growth and postantifungal effects in Candida albicans isolates. In the postantifungal effect experiments, prolonged concentration-dependent killing occurred. Maximum postantifungal effects occurred with caspofungin exposures of 5 or 15 min. A brief exposure of caspofungin eliminated the paradoxical growth that was observed in the time-kill experiments. The report by Shields et al. illustrates that short exposures to an echinocandin may lead to prolonged postantifungal effects and furthers our understanding of the paradoxical effect in C. albicans.

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Citations

Mar 7, 2014·Clinical Pharmacokinetics·Chris StockmannCatherine M T Sherwin
Nov 15, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas J WalshDavid R Andes
Aug 6, 2016·Diagnostic Microbiology and Infectious Disease·Sandra Gil-AlonsoGuillermo Quindós
Jul 27, 2017·The Journal of Pharmacy and Pharmacology·Akash Patil, Soumyajit Majumdar
Jan 27, 2018·Journal of Fungi·Johannes Wagener, Veronika Loiko

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