title: Comparison of in vitro antifungal activities of amphotericin B lipid complex with itraconazole against 708 clinical yeast isolates and opportunistic moulds determined by National Committee for Clinical Laboratory Standards methods M27-A and M38-P.
abstract: We compared the in vitro antifungal activity of amphotericin B lipid complex (ABLC) with that of itraconazole (ITZ) against 535 yeast strains and 173 opportunistic filamentous fungi by using a microdilution method (National Committee for Clinical Laboratory Standards M27-A and M38-P). The overall geometric mean MIC was 0.13 microg/ml and 0.177 microg/ml for ITZ and ABLC, respectively, and the MIC(50) was 0.125 microg/ml for both agents against yeast isolates. ITZ had a similar or slightly superior efficacy compared to ABLC when tested against Candida albicans, Candida parapsilosis, Cryptococcus neoformans, Candida krusei, Candida glabrata and Candida tropicalis. Effectiveness against C. glabrata was lower for ITZ (MIC(90) 2 microg/ml, and for ABLC, 0.5 microg/ml). For Aspergillus fumigatus, activity of ITZ was superior in comparison with ABLC (MIC(90) 1 and 16 microg/ml, respectively); MIC(90) for Aspergillus niger was 4 and 2 microg/ml for ABLC and ITZ, respectively. Scedosporium spp. showed a low susceptibility to both ABLC and ITZ. In conclusion, ABLC and ITZ are useful alternatives for the treatment of severe fungal infections. The selection of an antifungal agent should be made considering the toxicological and pharmacological properties and cost/benefit relationship and be supported by the susceptibility of the isolate.
authors.affiliation: Departamento de Microbiología, ACIA, Barcelona, Spain. acarrillo@ya.com
authors.forename: Alfonso Javier
authors.initials: AJ
authors.lastname: Carrillo-Muñoz
authors.forename: Maite
authors.initials: M
authors.lastname: Ruesga
authors.forename: Sonia
authors.initials: S
authors.lastname: Brio
authors.forename: Oscar
authors.initials: O
authors.lastname: del Valle
authors.forename: Virginia
authors.initials: V
authors.lastname: Rodriguez
authors.forename: Patricia
authors.initials: P
authors.lastname: Santos
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Hernández-Molina
authors.forename: Emilia
authors.initials: E
authors.lastname: Cantón
authors.forename: Javier
authors.initials: J
authors.lastname: Pemán
authors.forename: Josep
authors.initials: J
authors.lastname: Guarro
authors.forename: Guillermo
authors.initials: G
authors.lastname: Quindós
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D003470:Culture Media; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D025141:Drug Resistance, Fungal; D005658:Fungi / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards; D009894:Opportunistic Infections / Q000382:microbiology*; D010713:Phosphatidylcholines / Q000494:pharmacology*; D010715:Phosphatidylglycerols / Q000494:pharmacology*; D011786:Quality Control; D015003:Yeasts / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000935:Antifungal Agents; D003470:Culture Media; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D017964:Itraconazole; D000666:Amphotericin B