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Combining two antifungal agents does not enhance survival of Galleria mellonella larvae infected with Madurella mycetomatis
Author(s) -
Eadie Kimberly,
Parel Florianne,
Helvertvan Poppel Marilyn,
Fahal Ahmed,
Sande Wendy
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12871
Subject(s) - terbinafine , itraconazole , amphotericin b , mycosis , galleria mellonella , medicine , biology , pharmacology , microbiology and biotechnology , antifungal , immunology , biochemistry , virulence , gene
Objective To determine whether combination therapy would improve therapeutic outcome in eumycetoma caused by Madurella mycetomatis . Methods Survival, colony‐forming units ( CFU ), melanisation and histopathology in M. mycetomatis‐ infected Galleria mellonella larvae treated with amphotericin B, itraconazole, terbinafine or combinations thereof were determined. Results Compared to larvae treated with 5% glucose, enhanced survival was obtained when M. mycetomatis‐ infected larvae were treated with amphotericin B, but not when they were treated with itraconazole or terbinafine. Combination therapy did not increase survival compared to 5% glucose‐treated larvae, itraconazole‐treated larvae or terbinafine‐treated larvae. Compared to amphotericin B monotreatment, a significant decrease in survival was noted when this therapy was combined with either itraconazole or terbinafine. CFU , melanisation and histopathology did not differ between monotherapy, combination therapy or 5% glucose‐treated larvae. Conclusions Combining different classes of antifungal agents did not enhance the survival of M. mycetomatis‐ infected G. mellonella larvae. Instead of improving the therapeutic outcome, combining either itraconazole or terbinafine with amphotericin B resulted in significantly lower survival rates of infected larvae than amphotericin B monotherapy. This experimental study does not provide support for the use of combined amphotericin B and itraconazole, combined itraconazole and terbinafine or combined terbinafine and amphotericin B and should be confirmed in other animal models.