title: Combined activity in vitro of caspofungin, amphotericin B, and azole agents against itraconazole-resistant clinical isolates of Aspergillus fumigatus.
abstract: Interactions in vitro between amphotericin B, itraconazole, voriconazole, and caspofungin against itraconazole-resistant Aspergillus fumigatus clinical strains were determined. Differential results were obtained depending on the criteria (MIC or minimal effective concentration) used. Caspofungin and voriconazole exhibited the most potent interactions, with synergy against at least 50% of isolates, and the average fractional concentration index was 0.38. Antagonism was not found for any combination.
authors.affiliation: Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km 2. 28220 Majadahonda (Madrid), Spain. mcuenca-estrella@isciii.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Cuenca-Estrella
authors.forename: Alicia
authors.initials: A
authors.lastname: Gomez-Lopez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Effron
authors.forename: Laura
authors.initials: L
authors.lastname: Alcazar-Fuoli
authors.forename: Emilia
authors.initials: E
authors.lastname: Mellado
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Buitrago
authors.forename: Juan L
authors.initials: JL
authors.lastname: Rodriguez-Tudela
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D001232:Aspergillus fumigatus / Q000187:drug effects*; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D055666:Lipopeptides; D008826:Microbial Sensitivity Tests; D010456:Peptides, Cyclic / Q000494:pharmacology*; D011743:Pyrimidines / Q000494:pharmacology; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole
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