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Antimicrobial Agents and Chemotherapy
Article . 2026 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Safety and efficacy of echinocandin antifungal agents in Candida albicans endophthalmitis

Authors: Yue Zhang; Yi Tang; Yanjie Zhou; Hong Wu;

Safety and efficacy of echinocandin antifungal agents in Candida albicans endophthalmitis

Abstract

ABSTRACT To evaluate the safety and efficacy of echinocandins (rezafungin, RZF; anidulafungin, AFG) in Candida albicans (C. albicans ) endophthalmitis, with a particular focus on the novel drug RZF. In vitro safety was assessed by CCK-8 and live/dead staining on ARPE-19, Müller, and RAW 264.7. For in vivo safety, we administered therapeutic doses via intravitreal injection in rabbit eyes and performed fundus photography and histopathological analysis on day 3. Antifungal effect evaluation included minimum inhibitory concentration (MIC) determination, biofilm inhibition, and structural damage observation (confocal laser scanning microscopy, CLSM; scanning/transmission electron microscopy, SEM/TEM). We measured inflammatory responses via TNF-α/IL-1β qRT-PCR in RAW 264.7 cells. A rabbit C. albicans endophthalmitis model was established. At 48 h post-infection, rabbits received intravitreal injections of liposomal amphotericin B (L-AmB, 10 μg), voriconazole (VCZ, 50 μg), RZF (35 μg), AFG (35 μg), or saline (control). Clinical scores, ocular fungal burden, aqueous humor TNF-α, and histopathological scores were assessed. Echinocandins showed lower IC50 values in vitro , yet maintained acceptable safety at clinically relevant low concentrations compared with traditional drugs, with no significant tissue toxicity in vivo . RZF and AFG exhibited lower MICs (0.016–0.03125 μg/mL) than L-AmB (4 μg/mL) and VCZ (0.125–0.25 μg/mL). All four drugs inhibited biofilm formation, disrupted fungal structures, and downregulated inflammatory responses. In vivo , RZF/AFG reduced clinical and histopathological scores, fungal burden, and TNF-α levels, performing similarly to traditional drugs. RZF and AFG demonstrate potent antifungal activity against C. albicans comparable to conventional drugs, along with significant anti-inflammatory effects and acceptable safety profiles.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
hybrid