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Antifungal Activity of a Novel Triazole, Efinaconazole and Nine Comparators against 354 Molecularly Identified Aspergillus Isolates

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Abstract

Management of superficial aspergillosis is a major challenge owing to the frequent relapses and treatment failure, which may pose a potential risk, thereby gradually developing resistant species. Therefore, necessitating the development of new antifungals with higher potency should be considered as alternative strategies for efficient management of infections. We aimed to investigate the susceptibility of Aspergillus isolates toward a novel triazole, efinaconazole, in comparison with various classes of antifungal drugs. Antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute M38-A2 guidelines. Efinaconazole exhibited poor activity against mutant A. fumigatus strains, A. niger sensu stricto, and A. tubingensis with GM MIC values of 3.62, 1.62, and 2 μg/ml, respectively; however, surprisingly, it efficiently inhibited the growth of A. terreus sensu stricto, followed by wild-type A. fumigatus and A. flavus with GM MIC values of 0.29, 0.42, and 0.52 μg/ml, respectively. Presumably, efinaconazole is inefficient in aspergillosis treatment due to the low susceptibility of A. niger sensu stricto, A. tubingensis, and mutant A. fumigatus; however, it may be effective in treating superficial aspergillosis caused by wild-type A. fumigatus, A. terreus sensu stricto, and A. flavus. Further studies are needed to determine how these findings may translate into in vivo efficacy.

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Acknowledgements

We are grateful to our colleagues within the Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran, for fruitful discussion.

Funding

This study was financially supported by a grant from the National Institutes for Medical Research Development (NIMAD) (Grant No. 977223) and Mazandaran University of Medical Sciences (Sari, Iran) (Grant No. 3211) that we gratefully acknowledge.

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Correspondence to Hamid Badali.

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No potential conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Ethical permission for this study was approved by the Ethical Committee of Mazandaran University of Medical Sciences, Sari, Iran (nr. IR.MAZUMS.REC.1397.3211).

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Taheri Rizi, Z., Abastabar, M., Fakhim, H. et al. Antifungal Activity of a Novel Triazole, Efinaconazole and Nine Comparators against 354 Molecularly Identified Aspergillus Isolates. Mycopathologia 185, 357–365 (2020). https://doi.org/10.1007/s11046-020-00434-z

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