Córdoba Susana, Rodero Laura, Vivot Walter, Abrantes Rubén, Davel Graciela, Vitale Roxana G
Departamento de Micología, Instituto Nacional de Enfermedades Infecciosas (INEI), ANLIS Dr C.G. Malbrán, Buenos Aires, Argentina.
Int J Antimicrob Agents. 2008 Feb;31(2):171-4. doi: 10.1016/j.ijantimicag.2007.09.005. Epub 2007 Dec 3.
The in vitro activities of amphotericin B (AMB), itraconazole (ITC), voriconazole (VCZ) and terbinafine (TBF) alone and in the combinations AMB+VCZ, TBF+ITC and TBF+VCZ were evaluated against 29 clinical isolates of Fusarium spp. (15 Fusarium solani, 7 Fusarium oxysporum, 2 Fusarium decemcellulare, 2 Fusarium dimerum and 3 other Fusarium spp.). Minimum inhibitory concentrations were determined using the method of the Clinical and Laboratory Standards Institute and the interaction activity was calculated using the fractional inhibitory concentration index. The four antifungal drugs tested alone showed very limited activity against most of the isolates. In contrast, the combination TBF+VCZ showed synergy for 21 isolates. The combination AMB+VCZ showed synergism for only five strains. No interaction or antagonism was observed among the remaining strains. TBF+ITC showed no interaction for 18 strains. The in vitro antifungal activity of the drugs alone and in combination varied for different species. These results corroborate previous in vitro studies in which the combination TBF+VCZ showed synergy against Fusarium spp., although further studies are needed to elucidate its potential usefulness for therapy.
对两性霉素B（AMB）、伊曲康唑（ITC）、伏立康唑（VCZ）和特比萘芬（TBF）单独及AMB+VCZ、TBF+ITC和TBF+VCZ联合用药对29株镰刀菌属临床分离株（15株茄病镰刀菌、7株尖孢镰刀菌、2株十细胞镰刀菌、2株双隔镰刀菌和3株其他镰刀菌属）的体外活性进行了评估。采用临床和实验室标准协会的方法测定最低抑菌浓度，并使用部分抑菌浓度指数计算相互作用活性。单独测试的四种抗真菌药物对大多数分离株显示出非常有限的活性。相比之下，TBF+VCZ联合用药对21株分离株显示出协同作用。AMB+VCZ联合用药仅对五株菌株显示出协同作用。其余菌株未观察到相互作用或拮抗作用。TBF+ITC对18株菌株未显示相互作用。单独及联合用药时，药物的体外抗真菌活性因不同菌种而异。这些结果证实了先前的体外研究，其中TBF+VCZ联合用药对镰刀菌属显示出协同作用，尽管需要进一步研究以阐明其在治疗中的潜在用途。
