Activity of Voriconazole (V), Itraconazole (I) and Amphotericin B (A) In Vitro against 577 Molds from the Voriconazole Phase III Clinical Studies

A. Espinel-Ingroff, E. Johnson, P. Troke

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Background: As of Oct. 26th 2001, 577 mold isolates (isl) had been tested in vitro. Methods:Microtitre NCCLS M38P. Results: Isl were from 28 genera, 43 species and 306 patients (pts) in 17 countries. Most were from the US (231 isl; 141 pts), France (124; 52) and Germany (44; 28). Aspergillus spp dominated (413 isl, 71.6%) then Scedosporium spp (10.6%), Penicillium marneffei (5.9%) and Fusarium spp (3.1%). A. fumigatus (300/577, 51.9%) was the most common spp, then A. terreus (7.2%), S. apiospermum (6.4%) and P. marneffei. 49% of all isl (60% of aspergilli) were from bronchi, lungs or sinuses and 22% from the oropharynx. Other sites included bone, eye, liver, spleen, skin nodules and thyroid, plus brain/CNS (Aspergillus, Scedosporium or Rhizopus spp in 8 pts). The 118 US A. fumigatus isl had a wider MIC range for V (0.06- 8.0mg/L) than 182 non-US isl (0.12 - 0.5mg/L) but the same IC50 and IC90. The IC90 for I was the same as V but 7 isl (2 US) were resistant to I (4 - 16mg/L). 33 A fumigatus isl had MICs for A above 1.0mg/L. Only, 5.5% (32/577) of isl had an MIC above 2.0mg/L for V; one A. fumigatus (8.0mg/L) plus 31 others from 17 pts (Cylindrocarpon lichenicola, Fusarium spp, S. prolificans, Scopulariopsis brevicaulis, Microascus cinereus, P. verrucosum) and all Zygomycetes: (Absidia, Cunninghamella, Mucor, Rhizomucor and Rhizopus), Most of the 32 were unsusceptible to I (MIC ≷1.0mg/L - 22/29; 76%) or A (MIC ≷1.0mg/L - 22/30; 73%). Significant MIC change (≷2 dilutions) during V therapy was not seen. Conclusions: Most molds had MICs to V

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Full conference title: 

    • ICAAC 42nd