Ref ID: 5572
Author:
J. Guinea, T. Peláez, P. Muñoz, í“. Cuevas-Lobato, E. Bouza
Author address:
Madrid, ES
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
Abstract:
Objectives: Treatment of invasive aspergillosis is complicated by high toxicity and poor response.
Double-drug combinations are promising, but in vitro studies are necessary. We studied the activities of
voriconazole (VCZ, Pfizer), caspofungin (CAS, MSD) and terbinafine (TERB, Novartis) alone and
combined against clinical isolates of A. fumigatus in order to evaluate the potential of the combination of
TERB with the other two antifungal drugs.
Methods: We studied 10 strains of Aspergillus fumigatus from 10 hospitalized patients with proven
invasive aspergillosis (Ascioglu, CID 2002). Drug combinations were tested by using the guidelines
presented in document NCCLS M-38A, as modified for a broth microdilution checkerboard procedure. The
MIC for each drug was defined as the lowest concentration of antifungal drug that produced a complete
visual inhibition of fungal growth. Interactions between the drugs were studied by calculating the fractional
inhibitory concentration index (FICI) and interpreted as synergy (FICI < 0.5), antagonism (FICI > 4) and
indifference (FICI between 0.5 and 4). We calculated the MIC instead of the MEC for CAS in order to
compare the results with VCZ and TERB.
Results: The MIC90s and ranges of VCZ, CAS and TERB, in microg/ml, were: 1 (0.25-1), >4 and 4 (2- >
4) respectively. VCZ was the most active antifungal drug presenting the lowest MICs. The combination
VCZ-TERB proved to be synergistic in 90% of the strains (FICIs between 0.031 and 0.122). The
combination VCZ-CAS presented synergy in 10% of the strains (FICI 0.251), and the combination CASTERB
was indifferent for all strains. Antagonism was not present in any strain or combination. The strain
that showed indifference in the combination VCZ-TERB, also presented indifference in the other two
combinations.
Conclusions: The in vitro combination of terbinafine with voriconazole is synergistic against clinical
strains of Aspergillus fumigatus. In vivo studies are warranted.
Abstract Number: P744
Slides: y
Conference Year: 2006
Link to conference website: NULL
New link: NULL
Conference abstracts, posters & presentations
-
Title
Author
Year
Number
Poster
-
v
James Y. M. Tang *1, Chi-Ching Tsang 1, Haiyan Ye 2, Fanfan Xing 2, Simon Lo 2, Chenlu Xiao 3;4, Alan K. L. Wu 5, Antonio Ngan 1, Kwok Cheung Law 1;6, Ying Nam To 1;6, Dorothy T. T. Sze 1;7, Teresa W. S. Hui 1;6, Tianrenzheng Zhu 1;8, Chunyan Yao 1;9, Brian P. H. Tse 1;5, Susanna K. P. Lau 1;10;11, Patrick C. Y. Woo 1;10;11
4385
n/a
-
v
Anne-Pauline Bellanger 1, Florence Persat 2;3, Francoise Foulet 4;5, Christine Bonnal 6, Françoise Botterel 4;5, Eric Dannaoui *5;7
4369
n/a
-
v
María Ruiz-Ruigómez *1, Laura Corbella Vazquez 1, Isabel Rodriguez Goncer 1, Jose Tiago Sequeira 1, Maria Pilar Hernandez Jimenez 1, Francisco Lopez-Medrano 1, Rafael San Juan Garrido 1, Jose M. Aguado Garcia 1, Mario Fernandez Ruiz 2
4311
n/a
-
v
Karin Meinike Jørgensen *1, Raluca Datcu 1, Rasmus Krøger Hare 1, Maiken C. Arendrup 1;2;3
4266
n/a
-
v
Marion Helary, Cendrine Godet, Gilles Jebrak, Sandrine Houze, Hervé Mal, Christine Bonnal
4246
n/a
-
v
Liat Ashkenazi-Hoffnung *1;2, Efi Bilavski 1;2, Galia Grisaru 2;3, Efraim Sadot 2;3, Itzhak Levy 1;2, Salvador Fischer 1;2, Elhanan Nahum 1;2, Oded Scheuerman 1;2
4206
n/a
-
v
Hannah Nam *1, Michael G. Ison 2
4002
n/a
-
v
Timothy Erb 1, Renate Meyer 1, Elmar Kotter 2, Hartmut Bertz 3, Jürgen Held *1
3906
n/a
-
v
Laurence Bertrand
3887
n/a
-
v
Jean-Pierre Gangneux *1, Hélène Guegan 1, Alexandre Baudet 2, Olivier Blanchard 3, Monique Guillaso 2, Pierre Le Cann 3, EstelleBaures 3, Arnaud Florentin 2
3825
n/a