In vitro activities of voriconazole (UK-109,496) against fluconazole-susceptible and -resistant Candida albicans isolates from oral cavities of patients with human immunodeficiency virus infection

Abstract

The susceptibility of Candida albicans to a new antifungal triazole, voriconazole (UK-109,496), was investigated in 105 isolates obtained from the oral cavities of patients with human immunodeficiency virus (HIV) infection to study this drug's activity against fluconazole-susceptible and -resistant isolates. MICs were determined by a broth microdilution technique according to document M27-T from the National Committee for Clinical Laboratory Standards and by using a broth microdilution technique and a synthetic high-resolution medium. These antifungal susceptibility testing methods showed high levels of agreement (93% for fluconazole and 86% for voriconazole). Data from in vitro studies showed that voriconazole has good activity against fluconazole-susceptible and -resistant C. albicans isolates; the MICs at which 90% of all isolates were inhibited were 0.19 to 0.39 microgram/ml. We found that for isolates for which fluconazole MICs were high, voriconazole MICs were proportionally higher than those for fluconazole-susceptible C.albicans (P < 0.001). Pretreatment isolates from six patients with fluconazole-refractory esophageal candidiasis were included in the study. For these isolates the MICs were < or = 0.39 microgram/ml, and all patients responded to voriconazole. These results suggest that voriconazole is effective even in the treatment of fluconazole-refractory esophageal candidiasis and should be studied further to determine its clinical relevance in patients with HIV infection.

Activity of voriconazole, itraconazole, fluconazole and amphotericin B in vitro against 1763 yeasts from 472 patients in the voriconazole phase III clinical studies

“…It was notably more potent against C. krusei and C. glabrata than fluconazole and showed similar MICs to itraconazole for most susceptible isolates. This is consistent with published data for various isolate collections [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] and clinical cases [7,[18][19][20][21]23].…”

In vitro susceptibility testing of Candida and Aspergillus spp. to voriconazole and other antifungal agents using Etest®: results of a French multicentre study

“…Although several studies have indicated that voriconazole has good activity against fluconazole-resistant isolates of C. glabrata and C. albicans [16,38], voriconazole MICs have been found to be proportionally higher against these isolates [13,16,38]. Although resistance to voriconazole has not been widely reported, it is nevertheless important to monitor voriconazole MICs closely, particularly if this azole antifungal is used widely as empirical therapy and in the treatment of invasive fungal infections.…”

“…The quality control strains were C. parapsilosis ATCC 22019 and C. krusei ATCC 6258 [5,6], and the reference strains were C. albicans ATCC 90028 and Paecilomyces variotii ATCC 22391 [12,16]. The permitted range of MICs for these strains is shown in Table 1.…”

Fast, fully automated analysis of voriconazole from serum by LC–LC–ESI-MS–MS with parallel column-switching technique

“…A number of clinical reports about voriconazole pharmacokinetics have been published [2][3][4][5][6][7][8][9][10][11], as well as numerous data obtained in in vitro investigations on the pharmacokinetic properties and activity of voriconazole [12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”