Evaluación de la actividad in vitro y de la eficacia experimental in vivo de antibióticos antifúngicos frente a hongos oportunistas emergentes

Abstract

The treatment of invasive mycoses is far to be the optimal and despite advances made in the last decades these infections continue to be associated with high mortality rates. The main goal of this thesis was to evaluate the in vitro and in vivo efficacy of new therapeutical strategies against systemic infections such as candidiasis, aspergillosis and mucoramycosis. The best in vivo efficacy of echinocandins in the treatment of infections by Candida parapsilosis was only observed among those mice infected with the strains that showed the lowest MICs. Posaconazole showed good efficacy against infections by Aspergillus terreus. The voriconazole in vitro data could be useful for predicting the outcome of A. terreus infections; while A. fumigatus isolates showed important variability in their in vivo response to this drug. Amphotericin B was the most effective drug for the treatment of infections by Mucor circinelloides. Posaconazole and amphotericin B showed efficacy in the treatment of Apophysomyces variabilis infections. Posaconazole had the greatest efficacy in our model of disseminated infection by Saksenaea vasiformis.

Las terapias utilizadas en la actualidad para el tratamiento de infecciones fúngicas invasoras causadas por hongos oportunistas están lejos de ser las óptimas, y a pesar de los avances realizados en las últimas décadas, estas infecciones siguen asociadas a altas tasas de mortalidad. El objetivo principal de esta tesis ha sido contribuir al desarrollo experimental de nuevos tratamientos o a la mejora de los ya existentes frente a infecciones sistémicas como las candidiasis, aspergilosis y mucoramicosis. Para ello, se han realizado estudios in vitro e in vivo en modelos animales adecuados que han permitido comprobar la eficacia de diferentes fármacos.