title: Susceptibility testing of terbinafine alone and in combination with amphotericin B, itraconazole, or voriconazole against conidia and hyphae of dematiaceous molds.
abstract: Studies have demonstrated excellent in vivo efficacy of terbinafine combined with other antifungal agents against dematiaceous molds; however, there is a lack of in vitro studies. Most studies evaluated conidia inocula, but susceptibility testing of hyphae could mimic the fungal status in infected tissues and might reflect the therapeutic potential of the agent. We investigated the in vitro susceptibility of terbinafine alone and in combination with amphotericin B, itraconazole, or voriconazole against conidia by microdilution and dynamic measurement of hyphae growth of dematiaceous molds. The MIC values for hyphae were, until 3 dilutions, below the MIC obtained for conidia. The results indicated 100% synergistic interactions between terbinafine and azoles or amphotericin B in all tests, but lower MICs for hyphae. In conclusion, our findings allow us to say that the hyphal form of tested dematiaceous molds showed high susceptibility to all antifungal agents evaluated, alone and in combination with terbinafine.
authors.affiliation: Postgraduation Program, State University of Campinas, Sao Paulo, Brazil.
authors.forename: Fernanda Simas Corrêa
authors.initials: FS
authors.lastname: Biancalana
authors.forename: Luzia
authors.initials: L
authors.lastname: Lyra
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Moretti
authors.forename: Angélica Zaninelli
authors.initials: AZ
authors.lastname: Schreiber
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D004338:Drug Combinations; D004357:Drug Synergism; D005658:Fungi / Q000187:drug effects*; D025301:Hyphae / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D009281:Naphthalenes / Q000494:pharmacology*; D013172:Spores, Fungal / Q000187:drug effects*; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D009281:Naphthalenes; D000077291:Terbinafine