title: Antifungal activities of fluconazole, caspofungin (MK0991), and anidulafungin (LY 303366) alone and in combination against Candida spp. and Crytococcus neoformans via time-kill methods.
abstract: The activities of the echinocandins caspofungin and anidulafungin were evaluated alone and in combination with fluconazole using time-kill methods against isolates of Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, and Cryptococcus neoformans. Antifungal concentrations tested against each isolate were 0.5 microg/mL and 20 microg/mL of fluconazole and 0.007 microg/mL and 2 microg/mL of both caspofungin and anidulafungin. In addition, 20 microg/mL of fluconazole was tested with 2 microg/mL of caspofungin and anidulafungin to test for additive or antagonistic activity. Finally 0.5 microg/mL of fluconazole was tested with 0.007 microg/mL of caspofungin and anidulafungin to test for synergy. Combinations of fluconazole and caspofungin or anidulafungin resulted in indifference. Azole-echinocandin combinations do not produce antagonistic effects; therefore, combinations of these agents may warrant future clinical evaluation.
authors.affiliation: College of Pharmacy, The University of Iowa, Iowa City, Iowa 52242, USA.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Roling
authors.forename: Michael E
authors.initials: ME
authors.lastname: Klepser
authors.forename: Ashley
authors.initials: A
authors.lastname: Wasson
authors.forename: Russell E
authors.initials: RE
authors.lastname: Lewis
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Ernst
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pfaller
mesh_terms: D000077612:Anidulafungin; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D000077336:Caspofungin; D002455:Cell Division / Q000187:drug effects; D003455:Cryptococcus neoformans / Q000187:drug effects*; D026141:Drug Resistance, Multiple, Fungal; D004359:Drug Therapy, Combination; D054714:Echinocandins; D015725:Fluconazole / Q000494:pharmacology*; D006801:Humans; D055666:Lipopeptides; D016015:Logistic Models; D008826:Microbial Sensitivity Tests; D010455:Peptides; D010456:Peptides, Cyclic / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010455:Peptides; D010456:Peptides, Cyclic; D015725:Fluconazole; D000077612:Anidulafungin; D000077336:Caspofungin