Postantifungal effect and effects of low concentrations of amphotericin B and fluconazole on previously treated Candida albicans.

The objective of the study was to assess (a) the postantifungal effect (PAFE) of amphotericin B (AmB) and fluconazole (Flu) on two Candida albicans strains, and (b) the effect of low concentrations of AmB or Flu on yeasts previously exposed to AmB or Flu, respectively, in the presence or absence of 10% human serum. In the absence of serum, AmB exerted a positive effect (at 0.5-5.0 h) depending on the concentration and the strain used. Flu, however, produced negative effects (at -1.2 to -0.1 h). When the experiment was conducted in the presence of serum, the duration of all PAFEs increased significantly, especially those induced by Flu that became positive. Pretreated yeasts were more susceptible than untreated controls to the antifungal activity of low concentrations of the drugs. Growth delay was more pronounced with Flu (up to 5.2 h), whereas the greatest decrease in log10 at 12 h was slightly more pronounced for AmB. A knowledge of PAFEs and the effects of low drug concentrations on pretreated yeasts and the effects of serum on these is important in order to gain more insight into the in vivo activity of the study drugs.