JAC Advance Access published online on April 25, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg242
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Division of Infectious Diseases, Department of Medicine,
Wayne State University, 427 Lande Building,
550 E. Canfield, Detroit, MI 48201, USA
* Corresponding author. E-mail: aa1388{at}wayne.edu.
Received 3 December 2002
; revised 23 January 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
Differential activity of triazoles in two-drug
combinations with the echinocandin caspofungin against Aspergillus
fumigatus
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