Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Carrer Sant Llorenç, 21.43201 Reus, Tarragona, Spain.
Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Carrer Sant Llorenç, 21.43201 Reus, Tarragona, Spain.
Int J Antimicrob Agents. 2017 Apr;49(4):422-426. doi: 10.1016/j.ijantimicag.2016.12.015. Epub 2017 Feb 28.
In this study, the in vitro interactions of amphotericin B (AmB), voriconazole (VRC) and anidulafungin (AFG) in double and triple combinations against four species of multiresistant fungi (Fusarium solani, Lomentospora prolificans, Scopulariopsis brevicaulis and Scopulariopsis brumptii) were evaluated. In general, AmB combined with AFG was the most synergistic, especially against F. solani (7/8; 87.5%) when low concentrations of AmB were used, i.e. 0.125-0.5 µg/mL. The least active combination was AmB + VRC, with the lowest percentage of synergy against S. brevicaulis (2/11; 18.2%) and, in general, high concentrations of both antifungals were needed to achieve synergy. The triple combination was also highly synergistic against F. solani and S. brevicaulis, especially when the lowest concentrations of AmB were used, suggesting that use of combined therapies would reduce the toxicity of therapy. The triple combination was more effective than the double combinations in some cases, but not against all strains, suggesting that administration of three drugs is not always useful in the treatment of infections due to multiresistant fungi.
在这项研究中，评估了两性霉素 B（AmB）、伏立康唑（VRC）和安尼拉芬（AFG）在双药和三药联合治疗对四种多耐药真菌（茄病镰刀菌、繁茂枝孢霉、短帚霉和短帚霉）的体外相互作用。一般来说，AmB 与 AFG 联合使用最具协同作用，尤其是在使用低浓度 AmB（0.125-0.5μg/mL）时，对 F. solani（7/8；87.5%）的协同作用最强。AmB+VRC 联合使用的活性最低，对 S. brevicaulis（2/11；18.2%）的协同作用最低，通常需要高浓度的两种抗真菌药物才能达到协同作用。三药联合治疗对 F. solani 和 S. brevicaulis 也具有高度协同作用，尤其是在使用最低浓度的 AmB 时，这表明联合治疗可以降低治疗的毒性。在某些情况下，三药联合治疗比双药联合治疗更有效，但并非对所有菌株都有效，这表明在治疗多耐药真菌引起的感染时，使用三种药物并不总是有用。
