title: Evaluation of polyene-azole antagonism in liquid cultures of Candida albicans using an automated turbidometric method.
abstract: BACKGROUND
  A computerized machine, SPECTRAmax 340, was used to evaluate the recently reported phenomenon of antagonism of the polyene amphotericin B (AMB) in Candida albicans pre-exposed to the triazole fluconazole (FLZ).
  
  
  METHODS
  We investigated growth inhibition by varying concentrations of AMB in seven isolates of C. albicans pre-exposed to FLZ (50 microg/ml) for 18 h. All isolates were obtained on sequential visits from human immunodeficiency virus-infected patients not treated with FLZ.
  
  
  RESULTS
  Antagonism of AMB activity was observed in 5, 4, 2 and a single isolate for 0.5, 1, 2 and 3 microg/ml of the antifungal, respectively. In the majority of Candida isolates, antagonism was seen within a concentration range of 0.5-1.0 microg/ml AMB; 1 Candida strain (HK1-Sa) was resistant to 3 microg/ml AMB. Higher concentrations of AMB (>3 microg/ml) killed both the controls and FLZ-pre-exposed Candida cells. No significant differences were observed between the periods of antagonism observed for any of the sequential isolates or for any of the AMB concentrations or in the maxima of the growth curves obtained for all Candida isolates.
  
  
  CONCLUSIONS
  We conclude that the SPECTRAmax system is a useful tool to evaluate in vitro pharmacodynamic interactions between antifungal regimens within a fluid culture system, and provides information that cannot be obtained using traditional plate assay systems.
authors.affiliation: Oral Bio-Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China. lakshman@hkucc.hku.hk
authors.forename: Y H
authors.initials: YH
authors.lastname: Samaranayake
authors.forename: L P
authors.initials: LP
authors.lastname: Samaranayake
authors.forename: K W
authors.initials: KW
authors.lastname: Yeung
mesh_terms: D000666:Amphotericin B / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D000704:Analysis of Variance; D000935:Antifungal Agents / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D002176:Candida albicans / Q000187:drug effects* / Q000254:growth & development; D004353:Drug Evaluation, Preclinical; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D013045:Species Specificity
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole