The Impact of Lemongrass, Oregano, and Thyme Essential Oils on Candida Albicans’

Total Page:16

File Type:pdf, Size:1020Kb

The Impact of Lemongrass, Oregano, and Thyme Essential Oils on Candida Albicans’ Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2018 The mpI act of Lemongrass, Oregano, and Thyme Essential Oils on Candida albicans' Virulence Factors Jennifer Marie Eddins Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Alternative and Complementary Medicine Commons, Microbiology Commons, and the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Jennifer M. Eddins has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Aimee Ferraro, Committee Chairperson, Public Health Faculty Dr. Angela Prehn, Committee Member, Public Health Faculty Dr. Jagdish Khubchandani, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2018 Abstract The Impact of Lemongrass, Oregano, and Thyme Essential Oils on Candida albicans’ Virulence Factors by Jennifer M. Eddins BS, Colorado State University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2018 Abstract Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and combined, kill rates of fluconazole, caspofungin, and the kill rates when the antifungals were each combined with the 3 essential oils were compared using 117 isolates recovered from bloodstream infections between January 2009 through August 1, 2017. The data collected were analyzed using 2-way repeated ANOVAS. According to study results, there were statistically significant increases in kill rates when the isolates were exposed to any of the combinations of essential oils tested. Using binomial and multinomial regression to analyze age, gender, race, and comorbidities resulted in the age group 25-34, kidney failure, and solid organ tumor cancer all being statistically significantly associated with an increased risk for Candida albicans bloodstream infections, and multiple organ failure negatively associated with the risk. Health care practitioners can use the results of this study to reduce the number of patients becoming infected with life-threatening yeast infections, which could reduce the costs associated with infections. The Impact of Lemongrass, Oregano, and Thyme Essential Oils on Candida albicans’ Virulence Factors by Jennifer M. Eddins BS, Colorado State University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2018 Acknowledgments I would like to first and foremost thank God who I leaned on during much of this time. In addition, a big thank you to my family and friends who have supported and encouraged me throughout this process. I would also like to thank Dr. Aimee Ferraro and Dr. Angela Prehn for your support and guidance while creating, writing, and revising. Table of Contents List of Tables……………………………………………………………………………...v List of Figures…………………………………………………………………………....vii Chapter 1: Introduction to the Study ...................................................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................4 Purpose of the Study ......................................................................................................5 Research Questions and Hypotheses .............................................................................6 Theoretical Framework ..................................................................................................9 Nature of the Study ......................................................................................................11 Definitions....................................................................................................................12 Assumptions .................................................................................................................13 Scope and Delimitations ..............................................................................................14 Limitations ...................................................................................................................15 Significance of the Study .............................................................................................15 Summary and Transition ..............................................................................................16 Chapter 2: Literature Review .............................................................................................18 Introduction ..................................................................................................................18 Literature Search Strategy............................................................................................19 Theoretical Framework ................................................................................................20 Risk Factors Associated with Bloodstream Infections ................................................24 i Immunocompromised Patients, Infections, and Prophylactic Treatments ...................27 Virulence and Resistance .............................................................................................28 Alternative Treatment Options and Host Defenses .....................................................33 Essential Oil Treatments for Fungus and Yeast ...........................................................37 Chemical Composition and Mechanisms of Action of Lemongrass, Oregano, and Thyme Essential Oils ................................................................................38 Activity of Essential Oils Against Yeast and Fungus ..................................................40 Effects of Combining Antimicrobials and Essential Oils ............................................44 Evaluation of Host Cell Toxicity from Essential Oils .................................................47 Methodology Review ...................................................................................................49 Conclusion ...................................................................................................................51 Chapter 3: Research Method ..............................................................................................55 Introduction ..................................................................................................................55 Research Design and Rationale ...................................................................................56 Methodology ................................................................................................................58 Population ..............................................................................................................58 Sampling and Sampling Procedures ......................................................................59 Data Collection Procedure ...........................................................................................62 Instrumentation and Scale ............................................................................................62 Establishing Reliability for the Measurement and Scale .............................................65 Establishing Validity ....................................................................................................66 Addressing Potential Weaknesses and Threats to Validity..........................................68 ii Analysis........................................................................................................................69 Ethical Concerns ..........................................................................................................71 Summary ......................................................................................................................71 Chapter 4: Results ..............................................................................................................73 Introduction ..................................................................................................................73
Recommended publications
  • Comparative Evaluation of Isavuconazonium Sulfate
    Van Matre et al. Ann Clin Microbiol Antimicrob (2019) 18:13 https://doi.org/10.1186/s12941-019-0311-3 Annals of Clinical Microbiology and Antimicrobials RESEARCH Open Access Comparative evaluation of isavuconazonium sulfate, voriconazole, and posaconazole for the management of invasive fungal infections in an academic medical center Edward T. Van Matre1 , Shelby L. Evans2, Scott W. Mueller3, Robert MacLaren3, Douglas N. Fish3 and Tyree H. Kiser3,4* Abstract Background: Invasive fungal infections are a major cause of morbidity and mortality. Newer antifungals may provide similar efcacy with improved safety compared to older more established treatments. This study aimed to compare clinically relevant safety and efcacy outcomes in real world patients treated with isavuconazole, voriconazole, or posaconazole. Methods: This single center retrospective matched cohort study evaluated adults between January 2015 and Decem- ber 2017. The primary outcome was a composite safety analysis of antifungal related QTc prolongation, elevated liver function tests (> 5 times ULN), or any documented adverse drug event. Key secondary outcomes included: individual safety events, 30-day readmissions, magnitude of drug interactions with immunosuppressive therapy, and overall cost. Results: A total of 100 patients were included: 34 patients in the voriconazole group and 33 patients within each of the isavuconazole and posaconazole groups. The composite safety outcome occurred in 40% of the total cohort and was diferent between isavuconazole (24.2%), voriconazole (55.9%), and posaconazole (39.4%; p 0.028). Change in QTc (p < 0.01) and magnitude of immunosuppression dose reduction (p 0.029) were diferent between= the three groups. No diferences in mortality, length of stay, readmission, or infection= recurrence were observed between groups (p > 0.05 for all).
    [Show full text]
  • Candida Auris
    microorganisms Review Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities Suhail Ahmad * and Wadha Alfouzan Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; [email protected] * Correspondence: [email protected]; Tel.: +965-2463-6503 Abstract: Candida auris, a recently recognized, often multidrug-resistant yeast, has become a sig- nificant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently re- sulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris Citation: Ahmad, S.; Alfouzan, W. Candida auris: Epidemiology, infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new Diagnosis, Pathogenesis, Antifungal infections in healthcare facilities, including the screening of susceptible patients for colonization; the Susceptibility, and Infection Control cleaning and decontamination of the environment, equipment, and colonized patients; and successful Measures to Combat the Spread of approaches to identify and treat infected patients, particularly during outbreaks.
    [Show full text]
  • Systemic Antifungal Drug Use in Belgium—
    Received: 7 October 2018 | Revised: 28 March 2019 | Accepted: 14 March 2019 DOI: 10.1111/myc.12912 ORIGINAL ARTICLE Systemic antifungal drug use in Belgium—One of the biggest antifungal consumers in Europe Berdieke Goemaere1 | Katrien Lagrou2,3* | Isabel Spriet4,5 | Marijke Hendrickx1 | Eline Vandael6 | Pierre Becker1 | Boudewijn Catry6,7 1BCCM/IHEM Fungal Collection, Service of Mycology and Aerobiology, Sciensano, Summary Brussels, Belgium Background: Reports on the consumption of systemic antifungal drugs on a national 2 Department of Microbiology and level are scarce although of high interest to compare trends and the associated epi- Immunology, KU Leuven, Leuven, Belgium 3Clinical Department of Laboratory demiology in other countries and to assess the need for antifungal stewardship Medicine, National Reference Centre for programmes. Mycosis, University Hospitals Leuven, Leuven, Belgium Objectives: To estimate patterns of Belgian inpatient and outpatient antifungal use 4Department of Pharmaceutical and and provide reference data for other countries. Pharmacological Sciences, KU Leuven, Methods: Consumption records of antifungals were collected in Belgian hospitals Leuven, Belgium between 2003 and 2016. Primary healthcare data were available for the azoles for 5Pharmacy Department, University Hospitals Leuven, Leuven, Belgium the period 2010-2016. 6 Healthcare‐Associated Infections and Results: The majority of the antifungal consumption resulted from prescriptions of Antimicrobial Resistance, Sciensano, Brussels, Belgium fluconazole and itraconazole in the ambulatory care while hospitals were responsible 7Faculty of Medicine, Université Libre de for only 6.4% of the total national consumption and echinocandin use was limited. Bruxelles (ULB), Brussels, Belgium The annual average antifungal consumption in hospitals decreased significantly by Correspondence nearly 25% between 2003 and 2016, due to a decrease solely in non-university hos- Berdieke Goemaere, Sciensano, Mycology pitals.
    [Show full text]
  • Antifungals, Oral
    Antifungals, Oral Therapeutic Class Review (TCR) July 13, 2018 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. July 2018 Proprietary Information. Restricted Access – Do not disseminate or copy without approval. © 2004-2018 Magellan Rx Management. All Rights Reserved. FDA-APPROVED INDICATIONS Drug Manufacturer FDA-Approved Indication(s) for oral use clotrimazole generic .
    [Show full text]
  • Structural Diversity in Echinocandin Biosynthesis: the Impact of Oxidation Steps and Approaches Toward an Evolutionary Explanation
    Z. Naturforsch. 2017; 72(1-2)c: 1–20 Wolfgang Hüttel* Structural diversity in echinocandin biosynthesis: the impact of oxidation steps and approaches toward an evolutionary explanation DOI 10.1515/znc-2016-0156 can be well applied to parts of the pathway; however, thus Received July 29, 2016; revised July 29, 2016; accepted August 28, far, there is no comprehensive theory that could explain 2016 the entire biosynthesis. Abstract: Echinocandins are an important group of cyclic Keywords: antifungals; gene clusters; metabolic diversity; non-ribosomal peptides with strong antifungal activ- non-ribosomal peptide biosynthesis; secondary meta- ity produced by filamentous fungi from Aspergillaceae bolism; filamentous fungi. and Leotiomycetes. Their structure is characterized by numerous hydroxylated non-proteinogenic amino acids. Biosynthetic clusters discovered in the last years contain up to six oxygenases, all of which are involved in amino 1 Introduction acid modifications. Especially, variations in the oxidation Echinocandins are fungal non-ribosomal cyclic hexapep- pattern induced by these enzymes account for a remark- tides with a fatty acid side chain attached to a dihydroxy- able structural diversity among the echinocandins. This ornithine residue. As they are specific noncompetitive review provides an overview of the current knowledge of inhibitors of the β-1,3-glucan synthase involved in fungal echinocandin biosynthesis with a special focus on diver- cell wall biosynthesis, they have a pronounced antifungal sity-inducing oxidation steps. The emergence of metabolic bioactivity. Although natural echinocandins are not of diversity is further discussed on the basis of a comprehen- clinical use due to their toxicity and low solubility, chemi- sive overview of the structurally characterized echinocan- cal derivatives such as caspofungin, anidulafungin, and dins, their producer strains and biosynthetic clusters.
    [Show full text]
  • Lactoferrin, Chitosan and Melaleuca Alternifolia—Natural Products That
    b r a z i l i a n j o u r n a l o f m i c r o b i o l o g y 4 9 (2 0 1 8) 212–219 ht tp://www.bjmicrobiol.com.br/ Review Lactoferrin, chitosan and Melaleuca alternifolia—natural products that show promise in candidiasis treatment ∗ Lorena de Oliveira Felipe , Willer Ferreira da Silva Júnior, Katialaine Corrêa de Araújo, Daniela Leite Fabrino Universidade Federal de São João del-Rei/Campus Alto Paraopeba, Minas Gerais, MG, Brazil a r t i c l e i n f o a b s t r a c t Article history: The evolution of microorganisms resistant to many medicines has become a major chal- Received 18 August 2016 lenge for the scientific community around the world. Motivated by the gravity of such a Accepted 26 May 2017 situation, the World Health Organization released a report in 2014 with the aim of providing Available online 11 November 2017 updated information on this critical scenario. Among the most worrying microorganisms, Associate Editor: Luis Henrique species from the genus Candida have exhibited a high rate of resistance to antifungal drugs. Guimarães Therefore, the objective of this review is to show that the use of natural products (extracts or isolated biomolecules), along with conventional antifungal therapy, can be a very promising Keywords: strategy to overcome microbial multiresistance. Some promising alternatives are essential Candida oils of Melaleuca alternifolia (mainly composed of terpinen-4-ol, a type of monoterpene), lacto- Lactoferrin ferrin (a peptide isolated from milk) and chitosan (a copolymer from chitin).
    [Show full text]
  • A Fresh Look at Echinocandin Dosing
    J Antimicrob Chemother 2018; 73 Suppl 1: i44–i50 doi:10.1093/jac/dkx448 We can do better: a fresh look at echinocandin dosing Justin C. Bader1, Sujata M. Bhavnani1, David R. Andes2 and Paul G. Ambrose1* 1Institute for Clinical Pharmacodynamics (ICPD), Schenectady, NY, USA; 2University of Wisconsin, Madison, WI, USA *Corresponding author. Institute for Clinical Pharmacodynamics (ICPD), 242 Broadway, Schenectady, NY 12305, USA. Tel: !1-518-631-8101; Fax: !1-518-631-8199; E-mail: [email protected] First-line antifungal therapies are limited to azoles, polyenes and echinocandins, the former two of which are associated with high occurrences of severe treatment-emergent adverse events or frequent drug interactions. Among antifungals, echinocandins present a unique value proposition given their lower rates of toxic events as compared with azoles and polyenes. However, with the emergence of echinocandin-resistant Candida species and the fact that a pharmacometric approach to the development of anti-infective agents was not a main- stream practice at the time these agents were developed, we question whether echinocandins are being dosed optimally. This review presents pharmacokinetic/pharmacodynamic (PK/PD) evaluations for approved echino- candins (anidulafungin, caspofungin and micafungin) and rezafungin (previously CD101), an investigational agent. PK/PD-optimized regimens were evaluated to extend the utility of approved echinocandins when treating patients with resistant isolates. Although the benefits of these regimens were apparent, it was also clear that anidulafungin and micafungin, regardless of dosing adjustments, are unlikely to provide therapeutic exposures sufficient to treat highly resistant isolates. Day 1 probabilities of PK/PD target attainment of 5.2% and 85.1%, respectively, were achieved at the C.
    [Show full text]
  • Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives
    Current Fungal Infection Reports (2019) 13:45–58 https://doi.org/10.1007/s12281-019-00338-6 PHARMACOLOGY AND PHARMACODYNAMICS OF ANTIFUNGAL AGENTS (N BEYDA, SECTION EDITOR) Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives Ruchi Thakkar1,2 & Akash Patil1,2 & Tabish Mehraj1,2 & Narendar Dudhipala1,2 & Soumyajit Majumdar1,2 Published online: 2 May 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review In this review, a compilation on the current antifungal pharmacotherapy is discussed, with emphases on the updates in the formulation and clinical approaches of the routinely used antifungal drugs in ocular therapy. Recent Findings Natamycin (Natacyn® eye drops) remains the only approved medication in the management of ocular fungal infections. This monotherapy shows therapeutic outcomes in superficial ocular fungal infections, but in case of deep-seated mycoses or endophthalmitis, successful therapeutic outcomes are infrequent, as a result of which alternative therapies are sought. In such cases, amphotericin B, azoles, and echinocandins are used off-label, either in combination with natamycin or with each other (frequently) or as standalone monotherapies, and have provided effective therapeutic outcomes. Summary In recent times, amphotericin B, azoles, and echinocandins have come to occupy an important niche in ocular antifungal pharmacotherapy, along with natamycin (still the preferred choice in most clinical cases), in the management of ocular fungal infections.
    [Show full text]
  • Fd0063e4373375153919749a1d
    Echinocandin Treatment of Pneumocystis Pneumonia in Rodent Models Depletes Cysts Leaving Trophic Burdens That Cannot Transmit the Infection Melanie T. Cushion1,2*, Michael J. Linke2, Alan Ashbaugh1,2, Tom Sesterhenn1,2, Margaret S. Collins1,2, Keeley Lynch1,2, Ronald Brubaker3, Peter D. Walzer1,2 1 College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States of America, 2 Veterans Administration Medical Center, Cincinnati, Ohio, United States of America, 3 Department of Pathology, The Christ Hospital, Cincinnati, Ohio, United States of America Abstract Fungi in the genus Pneumocystis cause pneumonia (PCP) in hosts with debilitated immune systems and are emerging as co- morbidity factors associated with chronic diseases such as COPD. Limited therapeutic choices and poor understanding of the life cycle are a result of the inability of these fungi to grow outside the mammalian lung. Within the alveolar lumen, Pneumocystis spp., appear to have a bi-phasic life cycle consisting of an asexual phase characterized by binary fission of trophic forms and a sexual cycle resulting in formation of cysts, but the life cycle stage that transmits the infection is not known. The cysts, but not the trophic forms, express b -1,3-D-glucan synthetase and contain abundant b -1,3-D-glucan. Here we show that therapeutic and prophylactic treatment of PCP with echinocandins, compounds which inhibit the synthesis of b -1,3-D-glucan, depleted cysts in rodent models of PCP, while sparing the trophic forms which remained in significant numbers. Survival was enhanced in the echincandin treated mice, likely due to the decreased b -1,3-D-glucan content in the lungs of treated mice and rats which coincided with reductions of cyst numbers, and dramatic remodeling of organism morphology.
    [Show full text]
  • Micafungin in a Nutshell: State of Affairs on the Pharmacological and Clinical Aspects of the Novel Echinocandin
    Drug Evaluation Micafungin in a nutshell: state of affairs on the pharmacological and clinical aspects of the novel echinocandin Micafungin is one of three echinocandin antifungals approved by the US FDA and the European Medicines Agency (EMA). Like all echinocandin antifungals, micafungin inhibits the synthesis of 1,3‑b‑d‑glucan, a main component of the cell wall of many medically important fungi; thus, exerting fungicidal activity against most Candida spp., as well as fungistatic activity against many Aspergillus spp. Micafungin displays linear pharmacokinetics over the therapeutic range with a long half‑life, allowing once‑daily intravenous administration. Steady state serum concentrations are achieved after 3 days. Since therapeutic concentrations of micafungin are achieved after the administration of a standard dose there is no need for a loading dose. Interactions of micafungin with the cytochrome P450 (CYP3A4) system are marginal; and, consequently, no severe drug–drug interactions have been reported so far. Furthermore, micafungin exhibited favorable profiles for tolerability and safety; no dose‑limiting toxicity has been established yet. However, despite its favorable characteristics, these are no unique features among the echinocandins. Nevertheless, micafungin is the only echinocandin that has been approved for the prophylaxis of Candida spp. infections in patients undergoing hematopoietic stem cell transplantation. KEywords: antifungal agents n aspergillosis n candidiasis n dose–response Fedja Farowski†1, relationship n drug administration schedule n drug interactions n lipoproteins Jörg J Vehreschild2, n mycoses n peptides Oliver A Cornely1,3 & Maria JGT Vehreschild1 The incidence of invasive fungal diseases (IFDs) patients with febrile neutropenia (FN), treat- 1Klinikum der Universität zu Köln, has increased, mainly owing to the growing num- ment of esophageal candidiasis, candidemia Klinik I für Innere Medizin, 50924 Köln, ber of immunocompromised patients in recent and other spp.
    [Show full text]
  • Echinocandins As Biotechnological Tools for Treating Candida Auris Infections
    Journal of Fungi Review Echinocandins as Biotechnological Tools for Treating Candida auris Infections 1,2, 1, 1,2 Elizabete de Souza Cândido y , Flávia Affonseca y, Marlon Henrique Cardoso and Octavio Luiz Franco 1,2,* 1 S-Inova Biotech, Programa de Pós Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117900; Brazil; [email protected] (E.d.S.C.); flavia.aff[email protected] (F.A.); [email protected] (M.H.C.) 2 Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília 70790160, Brazil * Correspondence: [email protected] These authors equally contributed for this work. y Received: 31 July 2020; Accepted: 9 September 2020; Published: 22 September 2020 Abstract: Candida auris has been reported in the past few years as an invasive fungal pathogen of high interest. Its recent emergence in healthcare-associated infections triggered the efforts of researchers worldwide, seeking additional alternatives to the use of traditional antifungals such as azoles. Lipopeptides, specially the echinocandins, have been reported as an effective approach to control pathogenic fungi. However, despite its efficiency against C. auris, some isolates presented echinocandin resistance. Thus, therapies focused on echinocandins’ synergism with other antifungal drugs were widely explored, representing a novel possibility for the treatment of C. auris infections. Keywords: lipopeptides; echinocandins; Candida auris; infections; antifungal drugs 1. Introduction Candidiasis is one of the most common causes of fungal infection on a global scale and includes both superficial and invasive infections. The major concern is associated with patients in intensive care units (ICU) with high mortality rates. There are several fungal species isolated in the clinical setting responsible for these infections.
    [Show full text]
  • Estonian Statistics on Medicines 2016 1/41
    Estonian Statistics on Medicines 2016 ATC code ATC group / Active substance (rout of admin.) Quantity sold Unit DDD Unit DDD/1000/ day A ALIMENTARY TRACT AND METABOLISM 167,8985 A01 STOMATOLOGICAL PREPARATIONS 0,0738 A01A STOMATOLOGICAL PREPARATIONS 0,0738 A01AB Antiinfectives and antiseptics for local oral treatment 0,0738 A01AB09 Miconazole (O) 7088 g 0,2 g 0,0738 A01AB12 Hexetidine (O) 1951200 ml A01AB81 Neomycin+ Benzocaine (dental) 30200 pieces A01AB82 Demeclocycline+ Triamcinolone (dental) 680 g A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+ Thymol (dental) 3094 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+ Cetylpyridinium chloride (gingival) 227150 g A01AD81 Lidocaine+ Cetrimide (O) 30900 g A01AD82 Choline salicylate (O) 864720 pieces A01AD83 Lidocaine+ Chamomille extract (O) 370080 g A01AD90 Lidocaine+ Paraformaldehyde (dental) 405 g A02 DRUGS FOR ACID RELATED DISORDERS 47,1312 A02A ANTACIDS 1,0133 Combinations and complexes of aluminium, calcium and A02AD 1,0133 magnesium compounds A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 811120 pieces 10 pieces 0,1689 A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 3101974 ml 50 ml 0,1292 A02AD83 Calcium carbonate+ Magnesium carbonate (O) 3434232 pieces 10 pieces 0,7152 DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 46,1179 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 2,3855 A02BA02 Ranitidine (O) 340327,5 g 0,3 g 2,3624 A02BA02 Ranitidine (P) 3318,25 g 0,3 g 0,0230 A02BC Proton pump inhibitors 43,7324 A02BC01 Omeprazole
    [Show full text]