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Trichosporon  spp. are emerging opportunistic fungi associated with invasive infections, especially in patients with haematological malignancies. The present study investigated the  in vitro  inhibition of efflux pumps by promethazine (PMZ) as a strategy to control  T. asahii  and  T. inkin . Planktonic cells were evaluated for antifungal susceptibility to PMZ, as well as inhibition of efflux. The effect of PMZ was also studied in  Trichosporon  biofilms. PMZ inhibited  T. asahii  and  T. inkin  planktonic cells at concentrations ranging from 32 to 256 μg   ml –1 . Subinhibitory concentrations of PMZ inhibited efflux activity in  Trichosporon . Biofilms were completely eradicated by PMZ. PMZ potentiated the action of antifungals, affected the morphology, changed the amount of carbohydrates and proteins and reduced the amount of persister cells inside biofilms. The results showed indirect evidences of the occurrence of efflux pumps in  Trichosporon  and opens a perspective for the use of this target in the control of trichosporonosis.

Promethazine inhibits efflux, enhances antifungal susceptibility and disrupts biofilm structure and functioning in Trichosporon