title: In vitro activity of itraconazole in combination with terbinafine against clinical strains of itraconazole-insensitive Sporothrix schenckii.
abstract: Four strains of Sporothrix schenckii were isolated from patients with cutaneous sporotrichosis who failed itraconazole (ITC) treatment. To investigate the susceptibility of these strains to ITC and terbinafine (TRB) alone and in combination in 2 growth phases in vitro, a checkerboard microdilution method was used in accordance with the recommendations of the Clinical Laboratory Standards Institute (CLSI) was used in our study. The drug interaction was evaluated by assessing the fractional inhibitory concentration index (FICI). The geometric means (GMs) of the minimum inhibitory concentrations (MICs) of 4 insensitive strains were obviously higher than those of the sensitive isolates used for comparison. The FICI analysis revealed that only 2 isolates (25%) were synergistic in yeast form. Our results indicate the failure of clinical treatments might be caused by the insensitivity to ITC of these strains.
authors.affiliation: Department of Dermatology and Venereology, The Third Affiliated Hospital Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.forename: Huaiqiu
authors.initials: H
authors.lastname: Huang
authors.forename: Peiying
authors.initials: P
authors.lastname: Feng
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhong
authors.forename: Ruzeng
authors.initials: R
authors.lastname: Xue
authors.forename: Zhi
authors.initials: Z
authors.lastname: Xie
authors.forename: Meirong
authors.initials: M
authors.lastname: Li
authors.forename: Liyan
authors.initials: L
authors.lastname: Xi
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D004347:Drug Interactions; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D066298:In Vitro Techniques; D017964:Itraconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D009281:Naphthalenes / Q000494:pharmacology*; D013175:Sporothrix / Q000187:drug effects* / Q000302:isolation & purification; D013174:Sporotrichosis / Q000188:drug therapy / Q000382:microbiology; D018709:Statistics, Nonparametric; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D000077291:Terbinafine