Abstract
ABSTRACTThe vaginal environment with candidiasis has a pH of 3.8 to 4.5 and this has a negative effect on the activity of antifungals. Ibrexafungerp was evaluated against 187 Candida isolates, including fluconazole-sensitive and -resistant Candida albicans, Candida glabrata, Candida krusei, Candida parapsilosis, and Candida tropicalis with the media adjusted to pH 7.0 and pH 4.5. Ibrexafungerp MIC values were not adversely affected when tested at pH 4.5. Ibrexafungerp exhibited significant activity against all isolates at pH 4.5.
Highlights
Vulvovaginal candidiasis (VVC) is a common fungal infection that affects up to 8 in 10 women in their lifetime, with 40% to 45% experiencing two or more episodes [1, 2]
Ibrexafungerp is being developed for the treatment of vulvovaginal candidiasis, as well as systemic fungal infections due to resistant isolates
This study evaluated the effect of low-pH environments on the in vitro activity of ibrexafungerp against clinical vulvovaginal isolates, including isolates resistant to fluconazole
Summary
Vulvovaginal candidiasis (VVC) is a common fungal infection that affects up to 8 in 10 women in their lifetime, with 40% to 45% experiencing two or more episodes [1, 2]. Multiple previous in vitro studies have shown significantly reduced activity of fluconazole in low-pH testing environments, which is of concern given the vaginal pH found in women with VVC is invariably ,4.5 [11,12,13]. Antifungal agents selected for treating VVC should provide activity against all Candida spp. at a vaginal pH of 4 to 4.5 [14].
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