Posaconazole Prophylaxis in Experimental Systemic Zygomycosis

Author:

Barchiesi Francesco1,Spreghini Elisabetta1,Santinelli Alfredo2,Fothergill Annette W.3,Pisa Eleonora2,Giannini Daniele4,Rinaldi Michael G.35,Scalise Giorgio1

Affiliation:

1. Istituto di Malattie Infettive e Medicina Pubblica

2. Istituto di Anatomia Patologica

3. Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas

4. Centro Gestione Presidenza Medicina e Chirurgia, Università Politecnica delle Marche, Ancona, Italy

5. Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, Texas

Abstract

ABSTRACT Three isolates of zygomycetes belonging to two different genera ( Rhizopus oryzae and Absidia corymbifera ) were used to produce a systemic infection in neutropenic mice. On days −2 and −1 and at 2 h prior to infection, the mice received either posaconazole (POS) at doses ranging from 20 to 80 mg/kg of body weight/day or amphotericin B (AMB) at 1 mg/kg/day. Antifungal drug efficacy was assessed by determination of the prolongation of survival, determination of the percentage of infected organs (brain, lung, spleen, and kidney), and histological examination for the number of infection foci and their sizes in brain and kidney tissues. AMB significantly prolonged the survival of mice infected with all isolates. POS significantly prolonged the survival of mice infected with zygomycetes. Cultured organs from mice infected with R. oryzae were all positive, while treated mice challenged with A. corymbifera generally showed lower percentages of infected organs compared with the percentages for the controls. Zygomycete isolates established an active infection (the presence of hyphae) in the brains and the kidneys of all controls. In mice challenged with R. oryzae , both antifungal drugs were effective at reducing the number and the size of infection foci in the kidneys. Only AMB reduced the numbers, but not the sizes, of infection foci in the brain. Finally, both drugs significantly reduced the numbers and the sizes of infection foci in both tissues of mice infected with A. corymbifera . Our data suggest that prophylaxis with POS has some potential to prevent zygomycosis.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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