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Objective  The aims of this study were as follows. First, we sought to compare the  in vitro  susceptibility of liposomal amphotericin B (LAmB) and anidulafungin on  Candida albicans  and  Candida glabrata  biofilms growing on silicone discs. Second, we sought to compare the activity of LAmB versus anidulafungin for the treatment of experimental catheter-related  C .  albicans  and  C .  glabrata  infections with the antifungal lock technique in a rabbit model.    Methods  Two  C .  albicans  and two  C .  glabrata  clinical strains were used. The minimum biofilm eradication concentration for 90% eradication (MBEC 90 ) values were determined after 48h of treatment with LAmB and anidulafungin. Confocal microscopy was used to visualize the morphology and viability of yeasts growing in biofilms. Central venous catheters were inserted into New Zealand rabbits, which were inoculated of each strain of  C .  albicans  and  C .  glabrata . Then, catheters were treated for 48h with saline or with antifungal lock technique using either LAmB (5mg/mL) or anidulafungin (3.33mg/mL).    Results   In vitro : anidulafungin showed greater activity than LAmB against  C .  albicans  and  C .  glabrata  strains. For  C .  albicans : MBEC 90  of anidulafungin versus LAmB: CA176, 0.03 vs. 128 mg/L; CA180, 0.5 vs. 64 mg/L. For  C .  glabrata : MBEC 90  of anidulafungin versus LAmB: CG171, 0.5 vs. 64 mg/L; CG334, 2 vs. 32 mg/L.  In vivo : for  C .  albicans  species, LAmB and anidulafungin achieved significant reductions relative to growth control of log 10  cfu recovered from the catheter tips (CA176: 3.6±0.3 log 10  CFU, p≤0.0001; CA180: 3.8±0.1 log 10  CFU, p≤0.01). For  C .  glabrata , anidulafungin lock therapy achieved significant reductions relative to the other treatments (CG171: 4.8 log 10  CFU, p≤0.0001; CG334: 5.1 log 10  CFU, p≤0.0001)    Conclusions  For the  C .  albicans  strains, both LAmB and anidulafungin may be promising antifungal lock technique for long-term catheter-related infections; however, anidulafungin showed significantly higher activity than LAmB against the  C .  glabrata  strains.

plos one

Efficacy of liposomal amphotericin B and anidulafungin using an antifungal lock technique (ALT) for catheter-related Candida albicans and Candida glabrata infections in an experimental model