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Potential Inhibitory Effect of Miltefosine against Terbinafine-Resistant <i>Trichophyton indotineae</i>
oleh: Iman Haghani, Javad Akhtari, Zahra Yahyazadeh, Amirreza Espahbodi, Firoozeh Kermani, Javad Javidnia, Mohammad Taghi Hedayati, Tahereh Shokohi, Hamid Badali, Ali Rezaei-Matehkolaei, Seyed Reza Aghili, Ahmed Al-Rawahi, Ahmed Al-Harrasi, Mahdi Abastabar, Abdullah M. S. Al-Hatmi
Format: | Article |
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Diterbitkan: | MDPI AG 2023-04-01 |
Deskripsi
Several prolonged and significant outbreaks of dermatophytosis caused by <i>Trichophyton indotineae</i>, a new emerging terbinafine-resistant species, have been ongoing in India in recent years, and have since spread to various countries outside Asia. Miltefosine, an alkylphosphocholine, is the most recently approved drug for the treatment of both visceral and cutaneous leishmaniasis. Miltefosine in vitro activity against terbinafine-resistant and susceptible <i>T. mentagrophytes</i>/<i>T. interdigitale</i> species complex, including <i>T. indotineae</i>, is limited. The current study aimed to assess miltefosine’s in vitro activity against dermatophyte isolates, which are the most common causes of dermatophytosis. Miltefosine, terbinafine, butenafine, tolnaftate, and itraconazole susceptibility testing was performed using Clinical and Laboratory Standards Institute broth microdilution methods (CLSI M38-A3) against 40 terbinafine-resistant <i>T. indotineae</i> isolates and 40 terbinafine-susceptible <i>T. mentagrophytes</i>/<i>T. interdigitale</i> species complex isolates. Miltefosine had MIC ranges of 0.063–0.5 µg/mL and 0.125–0.25 µg/mL against both terbinafine-resistant and susceptible isolates. In terbinafine-resistant isolates, the MIC<sub>50</sub> and MIC<sub>90</sub> were 0.125 µg/mL and 0.25 µg/mL, respectively, and 0.25 µg/mL in susceptible isolates. Miltefosine had statistically significant differences in MIC results when compared to other antifungal agents (<i>p</i>-value 0.05) in terbinafine-resistant strains. Accordingly, the findings suggest that miltefosine has a potential activity for treating infections caused by terbinafine-resistant <i>T. indotineae.</i> However, further studies are needed to determine how well this in vitro activity translates into in vivo efficacy.