Objectives
The echinocandin class of antifungal agents has not been considered for treatment of vulvovaginal candidiasis (VVC) because currently available echinocandins are limited to IV administration. This study investigated the killing kinetics of the novel echinocandin, CD101, which is in development as a topical formulation, against Candida spp., including azole-S and -R strains, in conditions and at concentrations relevant to topical treatment of VVC.
Methods
Three strains (one azole-S and two azole-R) were selected for 5 Candida spp. including C. albicans , C. glabrata , C. tropicalis , C. parapsilosis and C. krusei (which is intrinsically azole-R and so only two isolates were evaluated). Time-kill assays used a starting inoculum of mid-10 ˆ 5 colony-forming units (CFU)/mL in 10 mL of vagina-simulative medium at pH 4.0. CD101 and an azole comparator, terconazole (TCZ), were used at fixed concentrations of 0, 2, 8, 32, and 128 μg/mL. Samples were taken at 0, 1, 3, 6, 9, 24, 48 and 72 h and were pelleted/washed 2X in phosphate-buffered saline (PBS) to remove residual drug then serial diluted in PBS and plated on SDA to enumerate CFU. Fungicidal activity was defined as a ≥3-log reduction in CFU from the starting assay inoculum.
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