[Short communication: In vitro activity of amphotericin B with fluconazole or voriconazole combinations against Candida albicans isolates]
- PMID: 18444574
[Short communication: In vitro activity of amphotericin B with fluconazole or voriconazole combinations against Candida albicans isolates]
Abstract
The aim of this study was to investigate the in vitro interaction of amphotericin B in combination with fluconazole or voriconazole against Candida albicans clinical isolates by using a broth microdilution checkerboard assay and E-test. A total of 30 C. albicans strains isolated from blood, urine, sputum and pus samples were included to the study and the minimum inhibitory concentrations (MICs) of amphotericin B (AMB), fluconazole (FLU) and voriconazole (VOR) were determined by broth microdilution method and E-test. All strains tested for susceptibility were interpreted as susceptible by both methods (FLU MICs < 8 microg/ml, VOR and AMB MICs < 1 microg/ml). The rates of MIC agreement between two methods were as follows: AMB, 83%; FLU, 97%; VOR, 97%. AMB+ FLU and AMB+VOR combinations were tested by checkerboard broth microdilution and E-test methods. The combination test results were determined by using the fractional inhibitory concentration (FIC) index as synergistic, indifferent or antagonistic. AMB+FLU combination tested by checkerboard broth microdilution revealed synergy in one strain (3.3%) and antagonism in none, while the same combination tested by E-test revealed synergy in two (6.6%) and antagonism in four (13.3%) strains. The strains which exhibited synergy were different from eachother in two assays. This combination led to indifferent results in 23 (76.6%) of the strains. On the other hand AMB+VOR combination yielded synergistic results in two (6.6%) strains by both of the methods, however, these two strains were again different from eachother. No antagonism was detected by AMB+VOR combination while the combination was indifferent in 26 (86.6%) of the strains. Agreement between the checkerboard and E-test results was 87%. Although significant synergy was not detected in AMB+azole combinations, it was yet hopeful to obtain no antagonism. However, multi-center, large-scale, well standardized in-vitro and clinical studies about AMB and azole interaction which is a matter of debate, are necessary.
Similar articles
-
In vitro activities of voriconazole in combination with three other antifungal agents against Candida glabrata.Antimicrob Agents Chemother. 2004 Sep;48(9):3317-22. doi: 10.1128/AAC.48.9.3317-3322.2004. Antimicrob Agents Chemother. 2004. PMID: 15328091 Free PMC article.
-
Activity of voriconazole, itraconazole, fluconazole and amphotericin B in vitro against 1763 yeasts from 472 patients in the voriconazole phase III clinical studies.Int J Antimicrob Agents. 2008 Dec;32(6):511-4. doi: 10.1016/j.ijantimicag.2008.05.023. Epub 2008 Sep 13. Int J Antimicrob Agents. 2008. PMID: 18790613
-
[Comparison of broth microdilution and E-test methods for the antifungal susceptibility testing of Candida spp. strains isolated from blood cultures].Mikrobiyol Bul. 2010 Apr;44(2):263-71. Mikrobiyol Bul. 2010. PMID: 20549961 Turkish.
-
[The activity of systemic antimycotic drug combinations].Rev Esp Quimioter. 2001 Mar;14(1):30-9. Rev Esp Quimioter. 2001. PMID: 11376347 Review. Spanish.
-
Antifungal activity of the new azole UK-109, 496 (voriconazole).Mycoses. 1999;42 Suppl 2:83-6. Mycoses. 1999. PMID: 10865910 Review.
Cited by
-
Effects of antifungal agents alone and in combination against Candida glabrata strains susceptible or resistant to fluconazole.Mycopathologia. 2012 Sep;174(3):215-21. doi: 10.1007/s11046-012-9538-7. Epub 2012 Apr 22. Mycopathologia. 2012. PMID: 22528740