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Journal of Antimicrobial Chemotherapy (1999) 43, 675-681
© 1999 The British Society for Antimicrobial Chemotherapy

Comparison of the toxicity of fluconazole and other azole antifungal drugs to murine and human granulocyte -macrophage progenitor cells in vitro

I. Benkoo*,a, F. Hernádia, A. Megyeria, A. Kissb, G. Somogyic, Z. Tegyeyd, F. Kraicsovitsd and P. Kovácsa

a Department of Pharmacology; b Second Department of Internal Medicine and; c Department of Forensic Medicine, University Medical School, Debrecen H-4012 POB 12; d Central Chemical Research Institute of the Hungarian Academy of Sciences, Budapest, Hungary

We studied the inhibitory effects on colony formation by granulocyte- macrophage colony forming units (cfu-gm) of eight azole antifungal agents in vitro. All agents, except fluconazole, inhibited colony formation dose-dependently with 50% inhibitory concentrations (IC 50) in the range of 0.78-49 µmol/L in cultures of murine and human bone marrow. For human cells, the IC 50 values were 0.553 mg/L for itraconazole, 1.24 mg/L for saperconazole, 2.58 mg/L for clotrimazole, 5.33 mg/L for miconazole, 6.17 mg/L for econazole, 6.27 mg/L for ketoconazole and 8.38 mg/L for oxiconazole. The IC 50 of itraconazole for human cfu-gm in vitro was similar to the plasma level of this drug recommended for systemic antifungal therapy (>0.5 mg/L) thus indicating the potential clinical relevance of our data. The IC 50 of ketoconazole for human cfu-gm in vitro may be exceeded by plasma levels produced in vivo by high (>=400 mg) doses, whereas fluconazole failed to reduce colony formation by 50% even at 100 mg/L, a concentration not reached in vivo even after extremely high doses (2000 mg/day). To most of the drugs studied, murine progenitor cells seemed to be less sensitive than the human ones. There was, however, a close correlation between the murine and human log IC 50 values of the drugs (r 2= 0.964, P< 0.001), suggesting that cultures of murine bone marrow may be suitable to predict the in-vitro toxicity of azole antifungals to human cfu-gm.

* Corresponding author. Tel and Fax: +36-52-427-899; E-mail: benko{at}king.pharmacol.dote.hu


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