Aantifungal agents were tested against 30 clinical isolates of Cryptococcus neoformans var. neoformans using the NCCLS method (M27-A2). Posaconazole, itraconazole and amphotericin B had lower MIC than the remaining four antifungal agents. The MIC result for posaconazole was over 220-fold lower active than fluconazole. Fluconazole MICs for most isolates fell within the dose-dependant range. The overall MIC ranges and MIC50s were amphotericin B (0.03-0.25; 0.25), fluconazole (0.5-64; 16), itraconazole (0.015-1; 0.125), terbinafine (0.06->2; 1), caspofungin (8-32; 32), voriconazole (0.015-0.5; 0.25), and posaconazole (0.015-0.25; 0.06 microg/ml), respectively. In conclusion, the MIC50s of these drugs did not exhibit any sign of an upward shift with the exception of fluconazole and tendency cross-resistance between the seven drugs was not observed. We conclude that in vitro resistance to antifungal agents has not significantly changed despite the recent wide-spread use of triazoles for long-term treatment of Cryptococcal meningitis.
Amphotericin B* ; Antifungal Agents ; Cryptococcus neoformans* ; Cryptococcus* ; Fluconazole* ; Itraconazole* ; Meningitis, Cryptococcal ; Triazoles