4.3 Article

In vitro synergisms obtained by amphotericin B and voriconazole associated with non-antifungal agents against Fusarium spp

期刊

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2011.05.007

关键词

Fusarium spp.; Susceptibility; Associations; Antifungal agents; Synergism

资金

  1. CNPq (the National Council for Scientific and Technological Development of Brazil)
  2. Laboratorio de Pesquisas Micologicas of Universidade Federal de Santa Maria, RS, Brazil

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Fusarium spp is an opportunistic fungal pathogen responsible for causing invasive hyalohyphomycosis in immunocompromised patients. Due to its susceptibility pattern with a remarkable resistance to antifungal agents the treatment failures and mortality rates are high. To overcome this situation, combination therapy may be considered which must be subjected to in vitro tests. In vitro activities of amphotericin B, itraconazole, and voriconazole associated with azithromycin, ciprofloxacin, fluvastatin, ibuprofen, metronidazole, and also the combination of amphotericin B plus rifampin against 23 strains of Fusarium spp. through the checkerboard technique based on M38-A2 [Clinical and Laboratory Standards Institute (2008). Reference method for broth dilution antifungal susceptibility testing of filamentous fungi; approved standard, 2nd ed. (CLSI document M38-A2) (ISBN 1-56238-668-9). Wayne, PA: CLSI] were evaluated. The best synergistic interactions with amphotericin B were with ibuprofen (43.5%) (FICI [fractional inhibitory concentration index] range = 0.25-2). Combinations with voriconazole showed synergism, mainly with ciprofloxacin (30.4%) (FICI range = 0.25-3) and metronidazole (30.4%) (FICI range = 0.1-4); however, all the combinations with itraconazole were indifferent. In general, antagonistic interactions were not registered. Our results showed that in vitro synergisms obtained by some combinations studied deserve attention since they were better than those showed by the antimycotic. (C) 2011 Elsevier Inc. All rights reserved.

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