JAC Advance Access originally published online on April 25, 2003
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Journal of Antimicrobial Chemotherapy (2003) 51, 1423-1425
© 2003 The British Society for Antimicrobial Chemotherapy
Differential activity of triazoles in two-drug combinations with the echinocandin caspofungin against Aspergillus fumigatus
Division of Infectious Diseases, Department of Medicine, Wayne State University, 427 Lande Building, 550 E. Canfield, Detroit, MI 48201, USA
Received 3 December 2002; returned 23 January 2003; revised 7 March 2003; accepted 9 March 2003
Objectives: We investigated the in vitro activity of various triazoles in two-drug combinations with the echinocandin caspofungin against clinical isolates of Aspergillus fumigatus.
Method: Conidial suspensions were prepared from 20 clinical isolates of A. fumigatus highly susceptible to itraconazole, voriconazole, posaconazole and ravuconazole (MIC-0 range 0.125–1 mg/L), and caspofungin (MIC-0 range 32–64 mg/L). The in vitro susceptibility of A. fumigatus to two-drug combinations of itraconazole, voriconazole, posaconazole and ravuconazole with caspofungin was evaluated by the fractional inhibitory concentration index (FICI) method.
Results: Two-drug combinations of caspofungin with itraconazole (FICI = 0.49 ± 0.04) or posaconazole (FICI = 0.32 ± 0.09) provided synergic interaction. On the other hand, ravuconazole (FICI = 0.61 ± 0.31) and voriconazole (FICI = 1.61 ± 0.42) in combination with caspofungin showed no interaction against A. fumigatus.
Conclusions: Our data show that the in vitro antifungal efficacies of combinations of members from two different classes are not always similar and hence are not predictable.
Keywords: triazoles, antifungal combination, caspofungin, Aspergillus fumigatus
* Corresponding author. Fax: +1-313-993-0302; E-mail: aa1388{at}wayne.edu
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