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Antimicrobial Agents and Chemotherapy, 03 1997, 575-577, Vol 41, No. 3
Copyright © 1997 by the American Society for Microbiology. All rights reserved.

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

M Ruhnke, A Schmidt-Westhausen and M Trautmann
Abteilung Innere Medizin und Poliklinik, Virchow-Klinikum der Humboldt- Universitat, Berlin, Germany. mruhnke@ukrv.de

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.


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