Itraconazole vs amphotericin B: in vitro comparative evaluation of the minimal inhibitory concentration (MIC) against clinically isolated yeasts
- 31 Downloads
Itraconazole is a triazole compound which, following several clinical trials, has begun to be used for therapy of mycotic infections. This new drug, with a broad-spectrum antifungal activity, can be orally administered. The Authors studied the in vitro susceptibility to amphotericin B and itraconazole of the following clinical isolates of pathogenic yeasts: 100 Candida albicans, 20 C. tropicalis, 20 C. parapsilosis, 8 C. guilliermondii, 6 C. pseudotropicalis, 24 Torulopsis glabrata and 16 Cryptococcus neoformans.
Serial two-fold dilutions, from 100 μg/ml to 0.04 μg/ml, of each drug were prepared in Yeast Nitrogen Base + Glucose 5%, after dissolving the itraconazole in dimethylsulfoxide (DMSO) and amphotericin B in 5% glucose solution. Amphotericin B (MIC90: 3.12 μg/ml) was found to have an average in vitro MIC six-fold lower than itraconazole (MIC90: 25 μg/ml).
Thus, even though itraconazole is active, amphotericin B remains one of the most effective of the antifungal drugs.
Key wordsamphotericin B itraconazole susceptibility testing yeast infections
Unable to display preview. Download preview PDF.
- 1.Medoff G, Brajtburg J, Kobayashi GS. Antifungal agents useful in therapy of systemic fungal infections. Ann Rev Pharmacol Toxicol 1983; 23: 303–30.Google Scholar
- 2.Medoff G, Kobayashi GS. Strategies in the treatment of systemic fungal infections. N Engl J Med 1980; 302: 145–55.Google Scholar
- 3.Dismukes WE and NIAID Collaborative Mycoses Study Group. Treatment of systemic mycoses with ketoconazole: emphasis on toxicity and efficacy in 52 patients. Ann Intern Med 1973; 98: 13–20.Google Scholar
- 4.Cauwembergh C. Itraconazole: the first orally active antifungal for single day treatment of vaginal candidiasis. Curr Ther Res 1987; 41: 210–14.Google Scholar
- 5.Delescluses J, Cauwembergh G, Degreef H. Itraconazole, a new orally active antifungal, in the treatment of pityriasis versicolor. Br J Dermatol 1986; 114: 701–3.Google Scholar
- 6.Borelli D. A clinical trial of itraconazole in the treatment of deep mycoses and leishmaniasis. Rev Infect Dis 1987; 9: S57-S63.Google Scholar
- 7.Negroni R, Palmieri O, Koren F, Tiraboschi IN, Galimberti RL. Oral treatment of paracoccidioidomycosis and histoplasmosis with itraconazole in humans. Rev Infect Dis 1987; 9: S47-S50.Google Scholar
- 8.Restrepo A, Robledo J, Gomez I, Tabares AM, Gutierrez R. Itraconazole therapy in lymphangitic and cutaneous sporotrichosis. Arch Dermatol 1986; 122: 413–7.Google Scholar
- 9.Van Cutsem J, Van Gerven F, Van De Ven MA, Borgers M, Janssen PAJ. Itraconazole, a new triazole that is orally active in aspergillosis. Antimicrob Agents Chemother 1984; 26: 527–34.Google Scholar
- 10.Lavalle P, Suchil P, De Ovando F, Reynoso S. Itraconazole for deep mycoses: preliminary experience in Mexico. Rev Infect Dis 1987; 9: S64-S70.Google Scholar
- 11.Sobel JD, Muller G. Comparison of itraconazole and ketoconazole in the treatment of experimental candidal vaginitis. Antimicrob. Agents Chemother 1984; 26: 266–7.Google Scholar
- 12.Viviani MA, Tortorano AM, Giani PC, et al. Itraconazole for cryptococcal infection in the acquired immune deficiency syndrome. Ann Intern Med 1987; 106: 166.Google Scholar
- 13.De Gas J, Eeftinck Schattenkerk JKM, Van Ketel RJ. Itraconazole as maintenance treatment for cryptococcal meningitis in the acquired immune deficiency syndrome. Br Med J 1988; 296 (30 Jan): 339.Google Scholar
- 14.Perfect JR, Durack DT. Treatment of experimental cryptococcal meningitis with amphotericin B, 5-fluorocytosine and ketoconazole. J Infect Dis 1982; 146: 429–35.Google Scholar
- 15.Perfect JR, Savani DV, Durack DT. Comparison of itraconazole and fluconazole in treatment of cryptococcal meningitis and candida pyelonephritis in rabbits. Antimicrob. Agents Chemother 1986; 29: 579–83.Google Scholar