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M9610457.TXT
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1996-01-30
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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).