Stevens DA; American Society for Microbiology. General Meeting.
Abstr Gen Meet Am Soc Microbiol. 1999 May 30-Jun 3; 99: 321 (abstract no. F-125).
Sta. Clara Valley Med. Ctr., San Jose, CA.
With increasing use of FZ, there is a worldwide trend of appearance of in vitro FZ-resistant C. albicans (Ca) and a rise of FZ-resistant Candida species, such as C. tropicalis (Ct), C. krusei (Ck) and C. glabrata (Cg), with therapeutic failure correlation. The present study was undertaken to compare the potency of two agents effective for treatment of thrush, FZ and CZ, against recent clinical isolates. Twenty Ca isolates selected for FZ-resistance (MIC divided by 32 mcg/ml) and unselected Ct, Ck (10 each) and Cg (20) had MICs determined by NCCLS broth macrodilution over a 0.25-0.5 to 64 mcg/ml range. For analysis, off-scale values were assumed to be the next dilution. For Ca, CA MICs ranged < or = 0.25- 8, geometric means (GM) for FZ and CZ were 93.7 and 2.1, respectively, and 95% confidence intervals (CI) were 73.3- 119.8 and 1.3-3.3. For Ck, FZ and CZ MICs ranged from 32->64 and 0.5-4, GM 64 and 1, and CI 46.0-89.1 and 0.60-1.70. For Ct, all FZ MIC were >64 and CZ 2-16, GM 128 and 8, CI 128 and 5.0-12.8. For Cg, MICs were < or = 0.5->64 and < or = 0.25-4, GM 12.6 and 1.4, and CI 5.8-27.3 and 0.9-2.1. Thus, overall in 59/60 instances FZ MIC >CZ (1 Cg was off scale susceptible to both). Marked disparities in MICS, evidenced by CI, reveal superior potency of CZ, with CZ GM 45-, 64-, 16-, and 9- fold lower than FZ for Ca, Ck, Ct, and Cg, respectively. Paired MIC comparisons by Mann-Whitney U test show CZ superiority p <0.0001 for each of the 4 species. In vitro-in vivo CZ correlation data is required, but this study suggests CZ may produce superior results in thrush Rx or prophylaxis in a time of FZ resistance.
Publication Types:
Keywords:
- Candida
- Candidiasis
- Candidiasis, Oral
- Clotrimazole
- Disease Susceptibility
- Fluconazole
- In Vitro
- Microbial Sensitivity Tests
Other ID:
UI: 102195718
From Meeting Abstracts