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Antimicrobial Agents and Chemotherapy, March 2003, p. 1068-1071, Vol. 47, No. 3
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.3.1068-1071.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

In Vitro Activities of Caspofungin Compared with Those of Fluconazole and Itraconazole against 3,959 Clinical Isolates of Candida spp., Including 157 Fluconazole-Resistant Isolates

M. A. Pfaller,1,2* D. J. Diekema,1,3 S. A. Messer,1 R. J. Hollis,1 and R. N. Jones4,5

Departments of Pathology,1 Epidemiology,2 Medicine, University of Iowa College of Medicine and College of Public Health, Iowa City,3 The Jones Group/JMI Laboratories, North Liberty, Iowa,4 Tufts University School of Medicine, Boston, Massachusetts5

Received 10 May 2002/ Returned for modification 13 November 2002/ Accepted 10 December 2002

Caspofungin is an echinocandin antifungal agent with broad-spectrum activity against Candida and Aspergillus spp. The in vitro activities of caspofungin against 3,959 isolates of Candida spp. obtained from over 95 different medical centers worldwide were compared with those of fluconazole and itraconazole. The MICs of the antifungal drugs were determined by broth microdilution tests performed according to the NCCLS method using RPMI 1640 as the test medium. Caspofungin was very active against Candida spp. (MIC at which 90% of the isolates were inhibited [MIC90], 1 µg/ml; 96% of MICs were <=2 µg/ml). Candida albicans, C. dubliniensis, C. tropicalis, and C. glabrata were the most susceptible species of Candida (MIC90, 0.25 to 0.5 µg/ml), and C. guilliermondii was the least susceptible (MIC90, >8 µg/ml). Caspofungin was very active against Candida spp., exhibiting high-level resistance to fluconazole and itraconazole (99% of MICs were <=1 µg/ml). These results provide further evidence for the spectrum and potency of caspofungin activity against a large and geographically diverse collection of clinically important isolates of Candida spp.

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

Antimicrobial Agents and Chemotherapy, March 2003, p. 1068-1071, Vol. 47, No. 3
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.3.1068-1071.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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