Differential activity of triazoles in two-drug combinations with the echinocandin caspofungin against Aspergillus fumigatus

Elias K. Manavathu, George J. Alangaden, Pranatharthi H. Chandrasekar

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

Objectives: We investigated the in vitro activity of various triazoles in two-drug combinations with the echinocandin caspofungin against clinical isolates of Aspergillus fumigatus. Method: Conidial suspensions were prepared from 20 clinical isolates of A. fumigatus highly susceptible to itraconazole, voriconazole, posaconazole and ravuconazole (MIC-0 range 0.125-1 mg/L), and caspofungin (MIC-0 range 32-64 mg/L). The in vitro susceptibility of A. fumigatus to two-drug combinations of itraconazole, voriconazole, posaconazole and ravuconazole with caspofungin was evaluated by the fractional inhibitory concentration index (FICI) method. Results: Two-drug combinations of caspofungin with itraconazole (FICI = 0.49 ± 0.04) or posaconazole (FICI = 0.32 ± 0.09) provided synergic interaction. On the other hand, ravuconazole (FICI = 0.61 ± 0.31) and voriconazole (FICI = 1.61 ± 0.42) in combination with caspofungin showed no interaction against A. fumigatus. Conclusions: Our data show that the in vitro antifungal efficacies of combinations of members from two different classes are not always similar and hence are not predictable.

Original languageEnglish (US)
Pages (from-to)1423-1425
Number of pages3
JournalJournal of Antimicrobial Chemotherapy
Volume51
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Keywords

  • Antifungal combination
  • Aspergillus fumigatus
  • Caspofungin
  • Triazoles

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases
  • Pharmacology

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