In vitro interaction of voriconazole with imipenem/cilastatin and piperacillin/tazobactam against clinical Candida albicans isolates

Ref ID: 14093

Author:

S.E.M.A. Keceli Ozcan, B. Mutlu

Author address:

Kocaeli University, KOCAELI, Turkey

Full conference title:

4th Trends in Medical Mycology

Date: 18 October 2014

Abstract:

Objectives: Patients suffering from invasive mycoses often receive concomitant antifungal
therapy and antibacterial agents. Currently, in our hospital, piperacillin/tazobactam (P/T) and
imipenem/cilastatin (I/C) and as an antifungal agent, voriconazole are used especially for the
treatment of febrile neutropenic patients. These antibiotics was previously observed to
demonstrate the in vitro synergistic interactions with an antifungal agent, caspofungin acetate.
It was also previously shown that fluoroquinolones enhanced the activity of caspofungin and
voriconazole. However, the interaction between P/T and I/C antibiotics with voriconazole
againstCandida albicans isolates is not clearly known yet.
Methods: Totally 25 C. albicans isolates isolated from various clinical sites were included into
this study. In vitro interaction of voriconazole with P/T and I/C antibiotics were tested by CLSI
M27-A2 microdilution chequerboard technique. The interaction was analyzed according to
values of fractional inhibitory concentration index (FICI). The breakpoint of minumum inhibitory
concentration value for voriconazole susceptibility was accepted as 8804;4 microgram/ml.
Results: Only in seven isolates synergistic interactions were observed (FICI8804;0.5); however, in
18 isolates additive or indifferent interactions were observed (FICI>0.5-2). There was no
antogonism detected between all isolates.
Conclusion: These interactions should also be tested in animal experiments and the results
should be confirmed with clinical experience. Although broad spectrum antibiotics were not
expected to have antifungal effect, the knowledge of the interaction between antifungals and
antibiotics may guide to treat immunosuppresed patients who are under risk of invasive
candidiasis.

Abstract Number: P277

Conference Year: 2009

Link to conference website: NULL

New link: NULL

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