In vitro activities of voriconazole, posaconazole, and fluconazole against 4,169 clinical isolates of Candida spp. and Cryptococcus neoformans collected during 2001 and 2002 in the ARTEMIS global antifungal surveillance program

We examined the in vitro activities of voriconazole, posaconazole, and fluconazole against 3,932 isolates of Candida spp. and 237 isolates of Cryptococcus neoformans obtained from over 100 medical centers worldwide during 2001 and 2002. The MICs of the antifungal drugs were determined by broth microdilution tests performed according to the National Committee for Clinical Laboratory Standards (NCCLS) methods using RPMI 1640 as the test medium. Voriconazole and posaconazole were very active against Candida spp. (97-98% susceptible at MICs less than or equal to1 mug/ml) and C. neoformans (98-100% susceptible at MICs less than or equal to1 mug/mL). C. albicans (MIC90, 0.015-0.03 mug/ml) was the most susceptible species of Candida to both agents and C. glabrata (MIC90, 1-2 mug/mL) was the least susceptible. Both voriconazole and posaconazole were more active than fluconazole against all Candida spp. and C neoformans. These results provide further evidence for the increased spectrum and potency of the new triazoles against a large and geographically diverse collection of opportunistic fungal pathogens. (C) 2004 Elsevier Inc. All rights reserved.