title: Synergistic effects of terbinafine and itraconazole on clinical isolates of Fonsecaea monophora.
abstract: Our objective was to develop new approaches to the chemotherapy of invasive infections caused by Fonsecaea monophora. The in vitro effects of a combination of terbinafine with itraconazole on 18 clinical isolates were evaluated using a checkerboard microdilution method. The mode of interaction between the two drugs on the 18 isolates was analyzed using fractional inhibitory concentration index (FICI) analysis. FICI analysis demonstrated that 12 (67%) were synergistic, 4 (22%) were additive, and 2 (11%) were indifferent, with no antagonism being observed. The minimal inhibitory concentrations (MICs) obtained with the terbinafine-itraconazole combination were within levels that can be achieved in plasma at clinically relevant doses. Our results indicate the terbinafine-itraconazole combination may be an effective therapy for Fonsecaea monophora infection, which should be tested in clinical setting with patients with this disease.
authors.affiliation: Department of Dermatology, Second Affiliated Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou 510120, China.
authors.forename: Jun-Min
authors.initials: JM
authors.lastname: ZHANG
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: XI
authors.forename: Hui
authors.initials: H
authors.lastname: ZHANG
authors.forename: Zhi
authors.initials: Z
authors.lastname: XIE
authors.forename: Jiu-Feng
authors.initials: JF
authors.lastname: SUN
authors.forename: Xi-Qing
authors.initials: XQ
authors.lastname: LI
authors.forename: Sha
authors.initials: S
authors.lastname: LU
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001203:Ascomycota / Q000187:drug effects*; D004357:Drug Synergism; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D009281:Naphthalenes / Q000494:pharmacology*; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D000077291:Terbinafine