Evidence map›Paper›PMID 37162367›Full record

ArticleAntimicrobial agents and chemotherapy2023

Heightened Efficacy of Anidulafungin When Used in Combination with Manogepix or 5-Flucytosine against Candida auris

Larissa L H John, Darren D Thomson, Tihana Bicanic, Martin Hoenigl, Alistair J P Brown, Thomas S Harrison, Elaine M Bignell

Abstract read
In one paragraph

Article in Antimicrobial agents and chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed.

  1. Review
  2. Review
  3. New Perspectives on Antimicrobial Agents: Fosmanogepix.Antimicrobial agents and chemotherapy · 2026
    Review
  4. Article
  5. Review
  6. Review
  7. Functional characterization ofFrontiers in microbiology · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Antifungal Susceptibilities of Rare Yeast Isolates.Journal of fungi (Basel, Switzerland) · 2025
    Article
  12. RapidmSphere · 2025
    Article
  13. Microorganisms · 2025
    Review
  14. Innovative antifungal strategies to combat drug-resistantFrontiers in cellular and infection microbiology · 2025
    Review
  15. The multidrug-resistantCurrent research in microbial sciences · 2025
    Review
  16. Review
  17. Article
  18. Review
  19. Review
  20. Current Perspectives of Antifungal Therapy: A Special Focus onJournal of fungi (Basel, Switzerland) · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Larissa L H JohnMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.ORCID 0000-0003-4558-6036
Darren D ThomsonMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.
Tihana BicanicMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.ORCID 0000-0002-2676-838X
Martin HoeniglDivision of Infectious Diseases, Medical University of Graz, Austria.
Alistair J P BrownMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.ORCID 0000-0003-1406-4251
Thomas S HarrisonMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.
Elaine M BignellMedical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, United Kingdom.ORCID 0000-0001-7748-1920

Funding

Biotechnology and Biological Sciences Research Council BB/V017004/1Medical Research Council MR/M026663/2Medical Research Council MR/N006364/2Medical Research Council MR/S001824/1Medical Research Council MR/S001824/2Medical Research Council MR/V033417/1MRF_ MRF-160-0009-ELP-BICA-C0802
6 · The paper itself

Abstract

Candida auris is an emerging, multidrug-resistant fungal pathogen that causes refractory colonization and life-threatening, invasive nosocomial infections. The high proportion of C. auris isolates that display antifungal resistance severely limits treatment options. Combination therapies provide a possible strategy by which to enhance antifungal efficacy and prevent the emergence of further resistance. Therefore, we examined drug combinations using antifungals that are already in clinical use or are undergoing clinical trials. Using checkerboard assays, we screened combinations of 5-flucytosine and manogepix (the active form of the novel antifungal drug fosmanogepix) with anidulafungin, amphotericin B, or voriconazole against drug resistant and susceptible C. auris isolates from clades I and III. Fractional inhibitory concentration indices (FICI values) of 0.28 to 0.75 and 0.36 to 1.02 were observed for combinations of anidulafungin with manogepix or 5-flucytosine, respectively, indicating synergistic activity. The high potency of these anidulafungin combinations was confirmed using live-cell microfluidics-assisted imaging of the fungal growth. In summary, combinations of anidulafungin with manogepix or 5-flucytosine show great potential against both resistant and susceptible C. auris isolates.

Indexed as

Antifungal AgentsFlucytosineAminopyridinesAnidulafunginCandidaCandida aurisIsoxazolesMicrobial Sensitivity TestsAminopyridinesAnidulafunginAntifungal AgentsAPX001AFlucytosineIsoxazolesanidulafunginantifungal combinationCandida aurisflucytosinemanogepixsynergy

Identifiers

PMID37162367
PMCPMC10269148

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.