Fixed-ratio combination testing of an echinocandin, anidulafungin, and an azole, voriconazole, against 1,467 Candida species isolates.

摘要

Anidulafungin is a newer echinocandin antifungal agent, approved by the United States Food and Drug Administration (U.S. FDA) in 2006 (18), with well-documented potency against Candida spp. and a MIC_(90) value of 0.06 fig/ml reported for a sample of 2,869 Candida albicans isolates across a 6-year collection (16). In common with other echinocandins, anidulafungin MIC_(90) values for C. parapsilosis and C. guilliermondii can be elevated (1 to 4 mug/ml) (8, 10, 16, 17). Voriconazole is a triazole antifungal that is structurally related to fluconazole (1). Voriconazole has broad-spectrum activity against Candida spp. and has been approved by the U.S. FDA for the treatment of esophageal candidiasis and invasive candidiasis in nonneutropenic patients (11, 19). Compared to fluconazole, voriconazole demonstrates enhanced activity against Candida spp. (5,15). Voriconazole is active against the commonly isolated species of Candida, including C. albicans (MIC_(90), 0.015 to 0.06 mug/ml), C. tropicalis (MIC_(90), 0.12 to 0.25 mug/ml), and C.parapsilosis (MIC_(90),0.06 to 0.12 mug/ml) (14,15). Notably, voriconazole is also active against C. krusei (MIC_(90), 0.5 fig/ml), a species considered to be intrinsically resistant to fluconazole (MIC_(90), 64 fig/ml) (14, 15). Although activity has also been demonstrated against C. glabrata, MICs are higher (MIC_(90), 1 to 2 mug/ml) and resistance is more common than with other species (4, 14, 15).