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Journal of Antimicrobial Chemotherapy (1995) 36, 787-793
© 1995 The British Society for Antimicrobial Chemotherapy

research-article

Itraconazole susceptibilities of fluconazole susceptible and resistant isolates of five Candida species

Elizabeth M. Johnson, Kathleen G. Davey, Adrien Szekely and David W. Warnock*

PHLS Mycology Reference Laboratory, Public Health Laboratory Kingsdown, Bristol BS2 8EL, UK

Received 19 April 1995; returned 7 June 1995; accepted 12 July 1995

*Corresponding author

The in-vitro susceptibilities of 1380 isolates of five Candida species were determined in order to establish whether isolates resistant to fluconazole were cross-resistant to itraconazole. IC30 values were determined by a broth microdilution method. 690 Candida albicans isolates, seven Candida glabrata isolates, seven Candida krusei isolates, 120 Candida parapsilosis isolates and 37 Candida tropicalis isolates were susceptible to both fluconazole (IC50 ≤ 32 mg/L) and itraconazole (IC50≤4 mg/L). Twenty eight of 160 C. albicans isolates (17.5%), 180 of 293 C. glabrata isolates (61.4%), six of 48 C. krusei isolates (12.5%), and 10 of 18 C. tropicalis isolates (55.5%) resistant to fluconazole (IC50≥ 64 mg/L) were also resistant to itraconazole (IC50≥ 8 mg/L). In contrast, drug-specific resistance to itraconazole was not observed in any of the isolates tested. However, the itraconazole IC50s for fluconazole susceptible isolates were lower than those for fluconazole resistant isolates, which suggests that patients who fail fluconazole treatment might require itraconazole at higher dosages than usual.


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