In vitro synergistic effects of antituberculous drugs plus antifungals against Coccidioides posadasii.
The aim of the present study was to evaluate the in vitro interactions of antituberculous drugs (ATDs) with antifungals against Coccidioides posadasii. Eighteen drug combinations, formed by an ATD (isoniazid, pyrazinamide or ethambutol) plus an antifungal (amphotericin B, ketoconazole, itraconazole, fluconazole, voriconazole or caspofungin), were tested using the checkerboard method. All the antimicrobial combinations inhibited C. posadasii strains and synergistic interactions were observed for 10 combinations. Antagonism between the tested drugs was not observed. Stronger synergistic interactions were seen in the combinations formed by triazoles plus ethambutol as well as itraconazole plus pyrazinamide. Further studies in animal models are needed to confirm the usefulness of these combinations.
Cordeiro
Rossana de Aguiar
Rde A
Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil. ross@uece.br
Brilhante
Raimunda Sâmia Nogueira
RS
Rocha
Marcos Fábio Gadelha
MF
Medrano
Delia Jessica Astete
DJ
Monteiro
André Jalles
AJ
Tavares
Juliane Lira
JL
de Lima
Rita Amanda Chaves
RA
de Camargo
Zoilo Pires
ZP
Sidrim
José Júlio Costa
JJ
D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology*; D000995:Antitubercular Agents / Q000494:pharmacology*; D000077336:Caspofungin; D003045:Coccidioides / Q000187:drug effects*; D003047:Coccidioidomycosis / Q000382:microbiology*; D004357:Drug Synergism; D054714:Echinocandins / Q000494:pharmacology; D004977:Ethambutol / Q000494:pharmacology; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D017964:Itraconazole / Q000494:pharmacology; D007654:Ketoconazole / Q000494:pharmacology; D055666:Lipopeptides; D008826:Microbial Sensitivity Tests; D011718:Pyrazinamide / Q000494:pharmacology; D011743:Pyrimidines / Q000494:pharmacology; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
D000935:Antifungal Agents; D000995:Antitubercular Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D011718:Pyrazinamide; D017964:Itraconazole; D000666:Amphotericin B; D004977:Ethambutol; D015725:Fluconazole; D000077336:Caspofungin; D065819:Voriconazole; D007654:Ketoconazole; D007538:Isoniazid