Is There in riot-in vitro Correlation between Antifungal Susceptibility, Species of Candida spp, and Clinical Outcome?

Vladimir KRCMERY Jr..


Introduction: The rates of fungal infections have increased in recent years because of advances in therapeutics and the AIDS epidemics. In addition to amphotericin B and flucytosine, then the only available systemic antifungal agents, new agents have been developed: ketoconazole, itraconazole, fluconazole, and tile lipid fm'mulations of amphotericin B. Unlike in vitro mltibacterial susceptibility testing, antifungal susceptibility testing has been hampered by a lack of standardized methodology and the lack of correlation between in vitro results and in rive outcome. The National Committee for Clinical Laboratory Standards (NCCLS) has proposed standardized methodology for antifungal susceptibility testing and tentative interpretative bleakpoints for tile triazole agents. Tile methodology remains to be validated for amphotericin B. Several studies showed correlation between resistance and infection outcome in HIVpositive individuals with eandidiasis treated with flueonazole, but other factors associated with inferior outcome were: prior therapy with fluconazole, low CD4 cell counts and tile progression of AIDS. Patients having Camiida spp. with MICs to fluconazole of 8-16 nll/l or more were associated with mole failules, prolonged therapy and mole relapses. Increasing the dose of fluconazole to 400 600 mg/day had no effect on outcome, because of late relapses. Some of those studies assessed the MICs to other antifungals such as amphotericin B, 5 flueonazole or itraconazNe. Two studies in HIV-negative patients, one in cancel and one in ICU

Full conference title: 

International Congress on Chemotherapy, 24th Meeting
    • ICC 24 th