他克莫司与伊曲康唑、特比萘芬、联苯苄唑和阿莫罗芬联合使用时，比曲安奈德更能协同作用于临床皮肤癣菌分离株。

Tacrolimus, not triamcinolone acetonide, interacts synergistically with itraconazole, terbinafine, bifonazole, and amorolfine against clinical dermatophyte isolates.

机构信息

Department of dermatology, Beijing Chao-Yang Hospital, Capital Medical University Beijing, 100020 Beijing, China.

Department of Medical Mycology, Shanghai Dermatology Hospital, 200443 Shanghai, China.

出版信息

J Mycol Med. 2018 Dec;28(4):612-616. doi: 10.1016/j.mycmed.2018.09.003. Epub 2018 Oct 15.

DOI:10.1016/j.mycmed.2018.09.003

PMID:30337054

Abstract

OBJECTIVES

To compare the in vitro interactions between tacrolimus (TAC)/triamcinolone acetonide (TRI) with itraconazole (ITC), terbinafine (TRB), bifonazole (BIZ), and amorolfine (AMF) in 28 clinical dermatophyte isolates, including 13 Trichophyton rubrum, 6 Trichophyton mentagrophytes, 5 Microsporum canis, and 4 Epidermophyton floccosum strains.

MATERIALS AND METHODS

The interactions between TAC or TRI with antifungal agents were tested according to the microdilution checkerboard technique adapted from the CLSI M38-A2 microdilution method.

RESULTS

TAC and TRI did not exhibit significant antifungal activity against the tested strains at the highest concentration (MICs>8μg/mL). However, a strong synergistic interaction was observed for combinations of TAC with ITC (53%), TRB (53%), or BIZ (63%) against Trichophyton strains. Comparatively, TRI/ITC (11%) and TRI/BIZ (16%) combinations showed weaker synergistic activity against the same Trichophyton strains. TAC also showed synergistic interaction with ITC against 20% M. canis strains, with TRB against 60% M. canis strains, and with BIZ against 25% E. floccosum strains. No synergism was observed when M. canis and E. floccosum strains were exposed to TRI in combination with these drugs. Antagonism was not observed for any combinations.

CONCLUSIONS

Compared with TRI, TAC showed better synergy when combined with antifungal agents, especially topical TRB and BIZ, against dermatophyte isolates.

摘要

目的

比较他克莫司（TAC）/曲安奈德（TRI）与伊曲康唑（ITC）、特比萘芬（TRB）、联苯苄唑（BIZ）和阿莫罗芬（AMF）在 28 株临床皮肤癣菌中的体外相互作用，包括 13 株红色毛癣菌、6 株须癣毛癣菌、5 株犬小孢子菌和 4 株絮状表皮癣菌。

材料和方法

根据 CLSI M38-A2 微量稀释法改编的微量稀释棋盘技术，检测 TAC 或 TRI 与抗真菌药物的相互作用。

结果

TAC 和 TRI 在最高浓度（MICs>8μg/mL）下对测试菌株没有表现出明显的抗真菌活性。然而，TAC 与 ITC（53%）、TRB（53%）或 BIZ（63%）联合使用对 Trichophyton 菌株表现出强烈的协同作用。相比之下，TRI/ITC（11%）和 TRI/BIZ（16%）联合对相同的 Trichophyton 菌株表现出较弱的协同活性。TAC 与 ITC 联合对 20%的犬小孢子菌菌株也表现出协同作用，与 TRB 联合对 60%的犬小孢子菌菌株，与 BIZ 联合对 25%的絮状表皮癣菌菌株。当 M. canis 和 E. floccosum 菌株暴露于与这些药物联合使用的 TRI 时，未观察到协同作用。未观察到任何组合的拮抗作用。