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Antimicrobial Agents and Chemotherapy, January 1999, p. 169-171, Vol. 43, No. 1
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

In Vitro Activities of Voriconazole, Fluconazole, and Itraconazole against 566 Clinical Isolates of Cryptococcus neoformans from the United States and Africa

M. A. Pfaller,1,* J. Zhang,1 S. A. Messer,1 M. E. Brandt,2 R. A. Hajjeh,2 C. J. Jessup,3 M. Tumberland,4 E. K. Mbidde,5 and M. A. Ghannoum3

Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa1; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia2; Mycology Reference Laboratory, Center for Medical Mycology, Department of Dermatology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio3; University of California San Francisco, San Francisco, California4; and Uganda Cancer Institute, Kampala, Uganda5

Received 5 June 1998/Returned for modification 18 September 1998/Accepted 9 October 1998

We investigated the in vitro activity of voriconazole compared to those of fluconazole and itraconazole against 566 clinical isolates of Cryptococcus neoformans from Africa (164) and the United States (402). Isolates were obtained from cerebrospinal fluid (362), blood (139), and miscellaneous sites (65). Voriconazole (MIC at which 90% of the isolates are inhibited [MIC90], 0.12 to 0.25 µg/ml) was more active than either itraconazole (MIC90, 0.5 µg/ml) or fluconazole (MIC90, 8.0 to 16 µg/ml) against both African and U.S. isolates. Isolates inhibited by >= 16 µg of fluconazole per ml were almost all (99%) inhibited by <= 1 µg of voriconazole per ml. These results suggest that voriconazole may be useful in the treatment of cryptococcosis.

* Corresponding author. Mailing address: Medical Microbiology Division, Department of Pathology, C606 GH, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 384-9566 or 335-8170. Fax: (319) 356-4916. E-mail: mpfaller{at}blue.weeg.uiowa.edu.

Antimicrobial Agents and Chemotherapy, January 1999, p. 169-171, Vol. 43, No. 1
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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