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JAC Advance Access originally published online on April 21, 2005
Journal of Antimicrobial Chemotherapy 2005 55(6):1020-1023; doi:10.1093/jac/dki131
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

In vitro interaction of micafungin with conventional and new antifungals against clinical isolates of Trichosporon, Sporobolomyces and Rhodotorula

Carolina Serena1, Marçal Mariné1, F. Javier Pastor1, Nicole Nolard2 and Josep Guarro1,*

1 Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain; 2 Scientific Institute of Public Health, Brussels, Belgium

* Corresponding author. Tel: +34-977-759359; Fax: +34-977-759322; Email: josep.guarro{at}urv.net

Objectives: The infections caused by basidiomycetous yeasts are often difficult to resolve. Combined therapy might be useful in those severe cases where a monotherapy was ineffective. The aim of this study was to evaluate the in vitro activity of combinations of micafungin with amphotericin B or fluconazole, itraconazole, voriconazole and ravuconazole against isolates of Trichosporon, Rhodotorula and Sporobolomyces.

Methods: Twenty-seven clinical isolates were tested, i.e. 10 of Trichosporon asahii, two of Trichosporon mucoides, five of Sporobolomyces salmonicolor and 10 of Rhodotorula glutinis. Drug interactions were assessed by the chequerboard technique using the NCCLS microdilution method (M27-A2). The fractional inhibitory concentration index (FICI) was used to classify drug interactions. Results were interpreted as follows: synergy (FICI ≤0.5), no interaction (FICI >0.5 and ≤4.0), or antagonism (FICI >4.0).

Results: Micafungin combined with amphotericin B showed the highest percentage of synergic interactions (78%) followed by micafungin/ravuconazole and micafungin/itraconazole (48% for each), and micafungin/fluconazole and micafungin/voriconazole (34% for each). Antagonism was not observed in any case.

Conclusions: Some of the combinations tested, especially micafungin/amphotericin B, have potential for the treatment of basidiomycetous yeast infections.

Keywords: basidiomycetous yeasts , antifungal susceptibility , combined therapy


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