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- Document 0457
- DOCN M9610457
- TI Correlation of in-vitro susceptibility test results with clinical
- response: a study of azole therapy in AIDS patients.
- DT 9601
- AU Rodriguez-Tudela JL; Martinez-Suarez JV; Dronda F; Laguna F; Chaves F;
- Valencia E; Unidad de Micologia, Instituto de Salud Carlos III, Madrid,;
- Spain.
- SO J Antimicrob Chemother. 1995 Jun;35(6):793-804. Unique Identifier :
- AIDSLINE MED/96047287
- AB The in-vitro susceptibilities of 40 clinical isolates of Candida
- albicans to ketoconazole and fluconazole were determined and an attempt
- was made to correlate these data with the clinical responses of the
- patients from whom the strains were originally isolated to treatment
- with these agents. Of 40 patients with the acquired immunodeficiency
- syndrome (AIDS) with oropharyngeal and/or oesophageal candidosis, 21
- received ketoconazole and 19 fluconazole. Susceptibility testing was
- performed by a microbroth dilution method with RPMI-2% glucose medium
- according to the recommendations of the National Committee for Clinical
- Laboratory Standards; growth inhibition was estimated
- spectrophotometrically and the MIC endpoint was defined in terms of the
- IC1/2. The MICs of 236 additional strains of C. albicans, which were
- also isolated from AIDS patients, were used to establish a
- susceptibility profile for this species. On the basis of the
- susceptibility test results and the clinical responses of the 40
- patients, the following tentative breakpoints for ketoconazole and
- fluconazole are proposed: patients with infections caused by C. albicans
- strains with MICs of ketoconazole and fluconazole or < or = 0.001 and <
- or = 0.25 mg/L respectively would be expected to respond to treatment
- with these agents and isolates with MICs which meet these criteria are
- therefore classified as susceptible; patients with infections caused by
- strains with MICs of ketoconazole and fluconazole of > or = 0.06 and >
- or = 16.0 mg/L respectively would not be expected to respond to
- treatment with these agents and isolates with MICs which meet these
- criteria are therefore classified as resistant; the response of patients
- with infections caused by strains with MICs of ketoconazole and
- fluconazole of 0.003-0.03 and 0.5-8.0 mg/L respectively cannot be
- reliably predicted and isolates with MICs which fall within these ranges
- are therefore classified as being of indeterminate susceptibility. The
- present study demonstrates that the results of in-vitro susceptibility
- testing with RPMI-2% glucose broth correlate with the clinical response
- to therapy and can be used to facilitate optimal treatment in AIDS
- patients with oropharyngeal and/or oesophageal candidosis.
- DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Antifungal
- Agents/*PHARMACOLOGY/*THERAPEUTIC USE Azoles/*PHARMACOLOGY/*THERAPEUTIC
- USE Candida albicans/*DRUG EFFECTS Candidiasis, Oral/*DRUG
- THERAPY/MICROBIOLOGY Female Human Male Microbial Sensitivity Tests
- Middle Age Prospective Studies Support, Non-U.S. Gov't Treatment
- Outcome CLINICAL TRIAL JOURNAL ARTICLE
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-