In vitro antifungal susceptibility profile of Iranian Fusarium isolates: Emphasising on the potent inhibitory effect of efinaconazole compared to other drugs.

Background: Fusarium species are opportunistic human pathogens that remarkably cause fungal infections ranging from superficial to fatal invasive disseminated infections. Fusarium species are notoriously resistant to the majority of antifungal agents.

Objectives: Therefore, detailed studies regarding in vitro susceptibility are required and may lead to a better prognosis of severe infections.

Methods: We evaluated 25 antifungal drugs in vitro against 282 clinical and environmental Fusarium isolates.

Results: Fusarium species demonstrated high MICs/MECs values to the most commonly used antifungal drugs in clinical practice. The geometric mean (GM) MICs for luliconazole (0.004 μg/ml) and lanoconazole (0.012 μg/ml) were the lowest, followed by efinaconazole (0.98 μg/ml) and amphotericin B (1.04 μg/ml).

Conclusions: Efinaconazole, a novel triazole, may be a promising candidate for the treatment of superficial Fusarium infections. Furthermore, the development of systemic formulations of these drugs as well as further in vitro and in vivo investigations could aid in the treatment of systemic fusariosis.