Journal of Antimicrobial Chemotherapy, Vol 39, 45-51, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
O Cirioni, A Giacometti and G Scalise
The anti-Pneumocystis carinii activity of atovaquone, dapsone and
sulphamethoxazole alone and combined with dihydrofolate reductase (DHFR)
inhibitors and macrolides was investigated against five clinical isolates
of P. carinii. The susceptibility tests were performed by inoculation of
the organisms on to cell monolayer and parasite count after 72 h incubation
at 37 degrees C. Culture plates were added to Dulbecco's modified Eagle's
medium containing serial dilutions of atovaquone, dapsone and
sulphamethoxazole alone or in combination with diaveridine, pyrimethamine,
trimethoprim, azithromycin, clarithromycin and roxithromycin. Atovaquone,
dapsone and sulphamethoxazole were found to be effective at levels well
below the concentrations that could be achieved clinically, while DHFR
inhibitors were shown to combine effectively with dapsone and
sulphamethoxazole. No synergy could be demonstrated between atovaquone and
DHFR inhibitors or macrolides. A mild synergic effect was noted when
macrolides were combined with dapsone and sulphamethoxazole. Pyrimethamine
(0.5 mg/L) combined with dapsone and trimethoprim (0.5 mg/L) combined with
sulphamethoxazole exerted the strongest inhibitory effect.
JOURNAL ARTICLE
In-vitro activity of atovaquone, sulphamethoxazole and dapsone alone and combined with inhibitors of dihydrofolate reductase and macrolides against Pneumocystis carinii
Institute of Infectious Diseases & Public Health, University of Ancona, Italy.
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