Lack of correlation of 24-vs. 48-h itraconazole minimum inhibitory concentrations with microbiological and survival outcomes in a guinea pig model of disseminated candidiasis

Odabasi Z., Paetznick V. L., Rodriguez J. R., Chen E., Rex J. H., Leitz G. J., ...More

MYCOSES, vol.53, no.5, pp.438-442, 2010 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 53 Issue: 5
  • Publication Date: 2010
  • Doi Number: 10.1111/j.1439-0507.2009.01733.x
  • Journal Name: MYCOSES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.438-442
  • Keywords: Itraconazole, trailing effect, candidiasis, ANTIFUNGAL SUSCEPTIBILITY TEST, IN-VITRO, BROTH MACRODILUTION, MULTICENTER EVALUATION, MURINE MODEL, MICRODILUTION, FLUCONAZOLE, 5-FLUOROCYTOSINE, QUANTITATION, INFECTION
  • Marmara University Affiliated: Yes

Abstract

P>A 'trailing' effect has been commonly observed when azole antifungals are tested against Candida spp. Previous experience with fluconazole indicates that 24-h minimum inhibitory concentration (MIC) values are more compatible endpoints when compared with clinical outcomes. We evaluated the trailing effect of Candida isolates tested with itraconazole in a guinea pig model of systemic candidiasis. Survival and organ burden were only significantly affected by using a higher dose of itraconazole, irrespective of the MIC differences at 24 and 48 h. A fluconazole-resistant strain with susceptible dose-dependent MICs to itraconazole was successfully treated with high-dose itraconazole. Our data suggests that survival and microbiological response depend more on drug dosing than on the trailing phenotype of the isolates.