Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi.
We examined the in vitro activity of caspofungin, posaconazole, voriconazole, ravuconazole, itraconazole, and amphotericin B against 448 recent clinical mold isolates. The endpoint for reading caspofungin was the minimum effective concentration (MEC). Among the triazoles, posaconazole was most active, inhibiting 95% of isolates at <or=1 microg/ml, followed by ravuconazole (91%), voriconazole (90%), and itraconazole (79%). Caspofungin and amphotericin B inhibited 93% and 89% of isolates at <or=1 microg/ml, respectively, with caspofungin demonstrating an MEC 90 of 0.12 microg/ml. All three new triazoles and caspofungin inhibited >95% of Aspergillus spp. at <or=1 microg/ml compared to 83% for itraconazole and 91% for amphotericin B. Amphotericin B inhibited only 38% of Aspergillus terreus isolates at <or=1 microg/ml, whereas the three new triazoles and caspofungin inhibited all A. terreus at <or=0.5 microg/ml. The new triazoles and caspofungin have excellent in vitro activity against a very large collection of recent clinical isolates of Aspergillus spp., and some in vitro activity against selected other filamentous fungi.
Diekema
D J
DJ
Department of Internal Medicine,University of Iowa College of Medicine, Iowa City, IA 52242, USA. daniel-diekema@uiowa.edu
Messer
S A
SA
Hollis
R J
RJ
Jones
R N
RN
Pfaller
M A
MA
D000666:Amphotericin B / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001230:Aspergillus / Q000187:drug effects; D000077336:Caspofungin; D054714:Echinocandins; D005658:Fungi / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D055666:Lipopeptides; D008826:Microbial Sensitivity Tests / Q000379:methods; D009181:Mycoses; D010407:Penicillium / Q000187:drug effects; D010455:Peptides; D010456:Peptides, Cyclic; D011743:Pyrimidines / Q000494:pharmacology*; D013844:Thiazoles / Q000494:pharmacology*; D014230:Triazoles / Q000494:pharmacology*; D065819:Voriconazole
D000900:Anti-Bacterial Agents; D054714:Echinocandins; D055666:Lipopeptides; D010455:Peptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D013844:Thiazoles; D014230:Triazoles; D017964:Itraconazole; C101425:posaconazole; D000666:Amphotericin B; C104066:ER 30346; D000077336:Caspofungin; D065819:Voriconazole