Correlation between in vitro susceptibility ofCandida albicans and fluconazole-resistant oropharyngeal candidiasis in HIV-infected patients

1993 ◽  
Vol 12 (12) ◽  
pp. 911-915 ◽  
Author(s):  
N. Troillet ◽  
C. Durussel ◽  
J. Bille ◽  
M. P. Glauser ◽  
J. P. Chave
Keyword(s):  
Oropharyngeal Candidiasis ◽  
In Vitro Susceptibility ◽  
Ofcandida Albicans ◽  
Fluconazole Resistant

scholarly journals In Vitro Comparative Efficacy of Voriconazole and Itraconazole against Fluconazole-Susceptible and -Resistant Cryptococcus neoformans Isolates

1998 ◽  
Vol 42 (2) ◽  
pp. 471-472 ◽  
Author(s):  
M. Hong Nguyen ◽  
Christine Y. Yu
Keyword(s):  
Cryptococcus Neoformans ◽  
Susceptibility Testing ◽  
Clinical Isolates ◽  
Comparative Efficacy ◽  
In Vitro Susceptibility ◽  
In Vitro Susceptibility Testing ◽  
Fluconazole Resistant ◽  
Dose Dependent

ABSTRACT In vitro susceptibility testing for 50 clinical isolates of fluconazole-susceptible or -resistant Cryptococcus neoformans was performed with itraconazole and voriconazole. Voriconazole was more potent than itraconazole for fluconazole-susceptible isolates and as potent as itraconazole for fluconazole-susceptible dose-dependent isolates and for fluconazole-resistant isolates. For fluconazole-resistant isolates, the voriconazole and itraconazole MICs ranged from 1 to 2 μg/ml.

Itraconazole cyclodextrin solution for fluconazole-refractory oropharyngeal candidiasis in AIDS: correlation of clinical response with in vitro susceptibility

AIDS ◽  
1996 ◽  
Vol 10 (12) ◽  
pp. 1369-1376 ◽  
Author(s):  
Peter Phillips ◽  
Janet Zemcov ◽  
Wafeeq Mahmood ◽  
Julio S.G. Montaner ◽  
Kevin Craib ◽  
...  
Keyword(s):  
Clinical Response ◽  
Oropharyngeal Candidiasis ◽  
In Vitro Susceptibility

scholarly journals Successful Treatment of Fluconazole-Resistant Oropharyngeal Candidiasis by a Combination of Fluconazole and Terbinafine

1999 ◽  
Vol 6 (6) ◽  
pp. 921-923 ◽  
Author(s):  
Mahmoud A. Ghannoum ◽  
Boni Elewski
Keyword(s):  
Candida Albicans ◽  
Clinical Symptoms ◽  
In Vitro Testing ◽  
Fungal Culture ◽  
Novel Therapies ◽  
Oropharyngeal Candidiasis ◽  
Therapy Failure ◽  
Fluconazole Therapy ◽  
Fluconazole Resistant

ABSTRACT Increasing incidence of resistance to conventional antifungal therapy has demanded that novel therapies be introduced. Recent in vitro studies have shown that combinations involving azoles and allylamines may be effective in inhibiting fluconazole-resistant fungi. In this report, we describe the case of a 39-year-old woman who presented with white patches on her buccal mucosa, tongue, and palate with a bright erythematous erosive base. A fungal culture revealedCandida albicans. The patient failed to respond to the initially prescribed fluconazole therapy. Failure of therapy can be attributed to a developed resistance to fluconazole from the patient’s intermittent use of this antifungal agent at varying dosages for the preceding 2 years due to a diagnosis of onychomycosis. In vitro testing of the culture from the patient showed elevated MICs of fluconazole, itraconzole, and terbinafine (MICs were 32, 0.5, and 64 μg/ml, respectively). Our goal was to combine therapies of fluconazole and terbinafine in an attempt to clear the fungal infection. Impressively, this combination resulted in the clearing of the clinical symptoms and the patient has successfully been asymptomatic for more than 12 months posttreatment.

scholarly journals Efficacy of D0870 treatment of experimental Candida vaginitis.

1997 ◽  
Vol 41 (7) ◽  
pp. 1455-1459 ◽  
Author(s):  
P L Fidel ◽  
J L Cutright ◽  
J D Sobel
Keyword(s):  
Oral Administration ◽  
Candida Glabrata ◽  
Vaginal Candidiasis ◽  
Daily Regimen ◽  
In Vitro Activity ◽  
Vaginal Infection ◽  
In Vitro Susceptibility ◽  
Fluconazole Resistant ◽  
Susceptibility Tests

In this study, oral administration of the triazole D0870 was compared to oral administration of fluconazole in the treatment of experimental vaginal candidiasis. With an estrogen-dependent murine model of Candida albicans vaginal infection, the effects of D0870 on several isolates, including fluconazole-susceptible and -resistant isolates, were tested. D0870, at doses of 0.5 and 2.5 mg/kg of body weight given once over the course of a 10-day infection, was effective in eradicating vaginitis caused by fluconazole-susceptible laboratory and clinical isolates, respectively. In contrast, a stricter treatment regimen (every 24 to 48 h) with 10 and 25 mg of fluconazole per kg was required to achieve similar reductions in vaginal fungal titers induced by the same isolates. Whereas fluconazole was consistently ineffective in infections induced by fluconazole-resistant isolates, as predicted by in vitro susceptibility tests, D0870 was effective, although a daily regimen of 25 mg/kg was required. Additional studies showed that despite the in vitro activity of D0870 against two clinical Candida glabrata isolates, neither D0870 nor fluconazole was effective at daily doses as high as 100 and 125 mg/kg, respectively. Taken together, although D0870 failed to show efficacy against experimental C. glabrata vaginitis, D0870 was superior to fluconazole in the treatment of experimental C. albicans vaginitis caused by isolates that were either susceptible or resistant to fluconazole.

Treatment of Azole-Resistant Oropharyngeal Candidiasis with Topical Amphotericin B

2002 ◽  
Vol 36 (9) ◽  
pp. 1383-1386 ◽  
Author(s):  
Shellee A Grim ◽  
Kelly M Smith ◽  
Frank Romanelli ◽  
Ighovwerha Ofotokun
Keyword(s):  
Amphotericin B ◽  
Oral Candidiasis ◽  
Symptomatic Improvement ◽  
Oropharyngeal Candidiasis ◽  
Double Blind ◽  
In Vitro Susceptibility ◽  
Product Formulation ◽  
Patient Reported ◽  
Susceptibility Tests

OBJECTIVE: To report a case of successful treatment of azole-refractory oropharyngeal candidiasis with topical amphotericin B. CASE SUMMARY: A 30-year-old white woman presented with recurrent oral thrush. The patient had been exposed to azole antifungals for >20 years, and in vitro susceptibility tests revealed class resistance. The patient started taking amphotericin B 100 mg oral suspension swish-and-spit 4 × daily. After 4 weeks of topical amphotericin B treatment, the patient reported significant symptomatic improvement. The oral candidiasis worsened following a course of oral antibiotics, but improved once the antibiotic was discontinued and after receiving amphotericin B swish-and-swallow for 4 additional weeks. DISCUSSION: Current Infectious Diseases Society of America guidelines include topical amphotericin B as a potentially effective option for the treatment of oropharyngeal candidiasis. There is limited evidence to support this recommendation. Besides lack of data, an appropriate dosing regimen and consistent means of product formulation need to be determined. CONCLUSIONS: This report demonstrates the potential role for topical amphotericin B in the treatment of azole-refractory oral candidiasis. Double-blind, randomized, controlled trials are needed to define dosing, efficacy, administration, and long-term safety of oral amphotericin B.

scholarly journals Efficacy of CS-758, a Novel Triazole, against Experimental Fluconazole-Resistant Oropharyngeal Candidiasis in Mice

2003 ◽  
Vol 47 (2) ◽  
pp. 601-606 ◽  
Author(s):  
Yasuki Kamai ◽  
Mikie Kubota ◽  
Takashi Fukuoka ◽  
Yoko Kamai ◽  
Naoyuki Maeda ◽  
...  
Keyword(s):  
Resistant Strain ◽  
Viable Cell ◽  
New Drugs ◽  
Histopathological Study ◽  
Strongly Correlated ◽  
Oropharyngeal Candidiasis ◽  
Cell Counts ◽  
Fluconazole Resistant ◽  
Dose Dependent

ABSTRACT The therapeutic efficacy of CS-758, a novel triazole, was evaluated against experimental murine oropharyngeal candidiasis induced by Candida albicans with various susceptibilities to fluconazole. Against infections induced by strains with various susceptibilities to fluconazole, the efficacy of fluconazole was strongly correlated with the MIC of fluconazole, as measured by the NCCLS method, and agreed with the NCCLS interpretive breakpoints, suggesting that the efficacies of new drugs could be predicted by using this model. The results of the fungal burden study corresponded with the results of the histopathological study. CS-758 exhibited potent in vitro activity (MICs, 0.004 to 0.06 μg/ml) against the strains used in this murine model including fluconazole-susceptible dose-dependent and fluconazole-resistant strains (fluconazole MICs, 16 to 64 μg/ml). CS-758 exhibited excellent efficacy against the infections induced by all the strains including a fluconazole-resistant strain, and the reductions in viable cell counts were significant at 10 and 50 mg/kg of body weight/dose. Fluconazole was not effective even at 50 mg/kg/dose against infections induced by a fluconazole-resistant strain (fluconazole MIC, 64 μg/ml). These results suggest that CS-758 is a promising compound for the treatment of oropharyngeal candidiasis including fluconazole-refractory infections.

scholarly journals Association of Fluconazole Area under the Concentration-Time Curve/MIC and Dose/MIC Ratios with Mortality in Nonneutropenic Patients with Candidemia

2006 ◽  
Vol 51 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Manjunath P. Pai ◽  
Robin S. Turpin ◽  
Kevin W. Garey
Keyword(s):  
Outcome Data ◽  
Time Curve ◽  
In Vitro Susceptibility ◽  
Concentration Time ◽  
Risk Of Mortality ◽  
Crude Mortality ◽  
Daily Dose ◽  
Fluconazole Resistant ◽  
Dose Dependent

ABSTRACT The present study tested in vitro susceptibility of Candida bloodstream isolates to fluconazole to determine if the ratio of the fluconazole area under the concentration-time curve (AUC) or weight-normalized daily dose (dosewn) to MIC correlated with mortality. Fluconazole susceptibility and outcome data were determined for 77 patients with a positive Candida blood culture between 2002 and 2005. The most commonly isolated Candida species were C. albicans (64%), C. glabrata (14%), C. parapsilosis (8%), C. tropicalis (6%), and C. lusitaniae (4%). Only two isolates were classified as fluconazole resistant by the CLSI M27-A2 method. Fluconazole MICs were highest against C. glabrata relative to other Candida species. Overall the crude mortality assessed at hospital discharge was 19.4% (n = 15). Mortality rates by species were as follows: C. albicans, 16.3%; C. glabrata, 36.4%; C. parapsilosis, 0%; C. tropicalis, 0%; C. lusitaniae, 33.3%. A mortality rate of 50% was noted among patients infected with nonsusceptible isolates (MIC ≥ 16 μg/ml) compared to 18% for patients infected with susceptible (MIC ≤ 8 μg/ml) isolates (P = 0.17). The fluconazole dosewn/MIC (24-h) values were significantly higher for the 62 survivors (13.3 ± 10.5 [mean ± standard deviation]) compared to the 15 nonsurvivors (7.0 ± 8.0) (P = 0.03). The fluconazole AUC/MIC (24 h) values also trended higher for survivors (775 ± 739) compared to nonsurvivors (589 ± 715) (P = 0.09). These data support the dose-dependent properties of fluconazole. Underdosing fluconazole against less-susceptible Candida isolates has the potential to increase the risk of mortality associated with candidemia.

Susceptibility of uncommon Candida species to systemic antifungals by the EUCAST methodology

2019 ◽  
Vol 58 (6) ◽  
pp. 848-851 ◽  
Author(s):  
Judith Díaz-García ◽  
Luis Alcalá ◽  
Pablo Martín-Rabadán ◽  
Aina Mesquida ◽  
Carlos Sánchez-Carrillo ◽  
...  
Keyword(s):  
Point Mutation ◽  
Candida Species ◽  
Antifungal Agents ◽  
Wild Type ◽  
In Vitro Susceptibility ◽  
Susceptibility Data ◽  
Fluconazole Resistant ◽  
Type C

Abstract The incidence of infections by uncommon Candida species has increased in recent years, however, in vitro susceptibility data are scarce. Here we assess the susceptibility of C. krusei, C. dubliniensis, C. lusitaniae, and C. guilliermondii complex isolates (n = 120) to antifungal agents by the EUCAST methodology. C. dubliniensis proved to be the most susceptible species, similar to that of C. albicans (P < .05), whereas C. guilliermondii was the least susceptible. Two C. krusei isolates were echinocandin-resistant and harbored a point mutation (L701M) in the FKS1. Some isolates were either fluconazole-resistant (C. lusitaniae, n = 2) or fluconazole non-wild type (C. guilliermondii, n = 3).

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