title: In vitro activities of voriconazole, fluconazole, and itraconazole against 566 clinical isolates of Cryptococcus neoformans from the United States and Africa.
abstract: We investigated the in vitro activity of voriconazole compared to those of fluconazole and itraconazole against 566 clinical isolates of Cryptococcus neoformans from Africa (164) and the United States (402). Isolates were obtained from cerebrospinal fluid (362), blood (139), and miscellaneous sites (65). Voriconazole (MIC at which 90% of the isolates are inhibited [MIC90], 0.12 to 0.25 microg/ml) was more active than either itraconazole (MIC90, 0.5 microg/ml) or fluconazole (MIC90, 8.0 to 16 microg/ml) against both African and U. S. isolates. Isolates inhibited by >/=16 microg of fluconazole per ml were almost all (99%) inhibited by </=1 microg of voriconazole per ml. These results suggest that voriconazole may be useful in the treatment of cryptococcosis.
authors.affiliation: Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA. mpfaller@blue.weeg.uiowa.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: S A
authors.initials: SA
authors.lastname: Messer
authors.forename: M E
authors.initials: ME
authors.lastname: Brandt
authors.forename: R A
authors.initials: RA
authors.lastname: Hajjeh
authors.forename: C J
authors.initials: CJ
authors.lastname: Jessup
authors.forename: M
authors.initials: M
authors.lastname: Tumberland
authors.forename: E K
authors.initials: EK
authors.lastname: Mbidde
authors.forename: M A
authors.initials: MA
authors.lastname: Ghannoum
mesh_terms: D000349:Africa; D000935:Antifungal Agents / Q000494:pharmacology*; D003455:Cryptococcus neoformans / Q000187:drug effects* / Q000302:isolation & purification; D015725:Fluconazole / Q000494:pharmacology*; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D011743:Pyrimidines / Q000494:pharmacology*; D014230:Triazoles / Q000494:pharmacology*; D014481:United States; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D015725:Fluconazole; D065819:Voriconazole