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Number of results

Journal

2010 | 5 | 2 | 194-197

Article title

Fluconazole, caspofungin, voriconazole in combination with amphotericin B

Content

Title variants

Languages of publication

EN

Abstracts

EN
Combined antifungal therapy has been suggested to enhance the efficacy and reduce the toxicity of antifungal agents. The aim of the study was to investigate the in vitro synergistic activity of caspofungin, voriconazole, and fluconazole with amphotericin B against ten isolates of Candida parapsilosis and Candida albicans strains which were resistant to azoles or amphotericin B. Three different antifungal combinations (amphotericin B [AP] - caspofungin [CS], amphotericin B - fluconazole [FL], and AP - voriconazole [VO]) were evaluated for in vitro synergistic effect by the microdilution checkerboard and E-test methods. For the majority of strains, the combination test showed indifferent activity. Via the E-test method, synergistic activity was seen in 3 strains in response to AP-CS combination treatment and in one strain after administration of AP-FL; however, no synergy was observed in response to combination treatment with P-VO. Antagonistic activity was the result in 1 strain treated with AP-CS as well as in 6 strains treated with AP-FL and AP-VO combinations. Via the microdilution test, no synergistic activity was seen after treatment with all 3 combinations. Antagonistic activity was the result in 2 strains with AP-CS, in 6 strains with AP-VO and in 5 strains with AP-FL combinations. Agreement between the checkerboard and E-test methods was observed to be approximately 72%. These combinations may be used in the case of antifungal resistance.

Keywords

Publisher

Journal

Year

Volume

5

Issue

2

Pages

194-197

Physical description

Dates

published
1 - 4 - 2010
online
17 - 4 - 2010

Contributors

author
  • Department of Microbiology, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
author
  • Department of Infectious Diseases, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
author
  • Department of Infectious Diseases, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
author
  • Department of Microbiology, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
author
  • Department of Microbiology, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
author
  • Department of Infectious Diseases, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey
  • Department of Infectious Diseases, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey

References

  • [1] Meletiadis J, Verweij PE, Te Dorsthorst DTA, Meis JFGM, Mouton JW. Assessing in vitro combinations of antifungal drugs against yeasts and filamentous fungi: comparison of different drug interaction models. Med Mycol 2005; 43: 133–152 http://dx.doi.org/10.1080/13693780410001731547[Crossref]
  • [2] Te Dorsthorst DTA, Verweij PE, Meletiadis J, Bergervoet M, Punt NC, Meis JFGM, Mouton JW.. In vitro interaction of flucytosine combined with amphotericin B or fluconazole against thirty-five yeast isolates determined by both the fractional inhibitory concentration index and the response surface approach. Antimicrob Agents Chemother 2002; 46: 2982–2989 http://dx.doi.org/10.1128/AAC.46.9.2982-2989.2002[Crossref]
  • [3] Shalit I, Shadkchan Y, Sarma Z, Osherow N. In vitro synergy of caspofungin and itraconazole agains Aspergillus spp.: MIC versus minimal effective concentration end points. Antimicrob Agents Chemother 2003; 47: 1416–1418 http://dx.doi.org/10.1128/AAC.47.4.1416-1418.2003[Crossref]
  • [4] Lewis RE, Diekema DJ, Messer SA, Pfaller MA, Klepser ME. Comparison of E-test, chequerboard dilution, and time-kill studies for the detection synergy or antagonism between antifungal agents tested against Candida species. J Antimicrob Chemother 2002; 49: 345–351 http://dx.doi.org/10.1093/jac/49.2.345[Crossref]
  • [5] Arikan S, Lozano-Chiu M, Paetznick V, Rex JH. In vitro synergy of caspofungin and amphotericin B against Aspergillus and Fusarium spp. Antimicrob Agents Chemother 2002; 46: 245–247 http://dx.doi.org/10.1128/AAC.46.1.245-247.2002[Crossref]
  • [6] White R, Burgess DS, Manduru M, Bosso JA. Comparison of three different ın vitro methods of detecting synergy: time-kill, checkerboard, and E-test. Antimicrob Agents Chemother 1996; 40: 1914–1918 [PubMed]
  • [7] Guinea J, Peláez T, Alcalá L, Bouza E. Correlation between the E-test and the CLSI M-38 A microdilution method to determine the activity of amphotericin B, voriconazole, and itraconazole against clinical isolates of Aspergillus fumigatus. Diagn Microbiol Infect Dis 2007; 57: 273–276 http://dx.doi.org/10.1016/j.diagmicrobio.2006.09.003[Crossref]
  • [8] Perea S, Gonzalez G, Fothergill AW, Kirkpatrick WR, Rinaldi MG, Patterson TF. In vitro interaction of caspofungin acetate with voriconazole against clinical isolates of Aspergillus spp. Antimicrob Agents Chemother 2002; 46: 3039–3041 http://dx.doi.org/10.1128/AAC.46.9.3039-3041.2002[Crossref]
  • [9] Kratzer C, Tobudic S, Schmoll M, Graninger W, Georgopoulus A. In vitro activity and synergism of amphotericin B, azoles and cationic antimicrobials against the emerging pathogen Trichoderma spp. J Antimicrob Chemother 2006; 58: 1058–1061 http://dx.doi.org/10.1093/jac/dkl384[Crossref]
  • [10] Barchiesi F, Spreghini E, Maracci M, Fothergill AW, Baldassarri I, Rinaldi MG, Scalise G. In vitro activities of voriconazole in combination with three other antifungal agents Candida glabrata. Antimicrob Agents Chemother 2004; 48: 3317–3322 http://dx.doi.org/10.1128/AAC.48.9.3317-3322.2004[Crossref]
  • [11] Sugar AM, Hitchcock CA, Troke PF, Picard M. Combination therapy of murine invasive candidiasis with fluconazole and amphotericin B. Antimicrob Agents Chemother 1995; 39: 598–601

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_s11536-010-0010-0
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