In vitro activity of voriconazole and amphotericin B against Candida albicans, Candida krusei, and Cryptococcus neoformans in human cerebrospinal fluid.

Purpose: Fungal central nervous system (CNS) infections show a high mortality rate and only a few antifungal agents are available to treat these infections. We hypothesize that the different biochemical properties of human cerebrospinal fluid (CSF) compared to the standard growth medium lead to the...

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Publicado en:Infection Vol. 47; no. 4; pp. 565 - 571
Autores principales: al Jalali, Valentin, Sauermann, Robert, Eberl, Sabine, Zeitlinger, Markus
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2019
      vid: 47
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-019-01275-9
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        atl: In vitro activity of voriconazole and amphotericin B against Candida albicans, Candida krusei, and Cryptococcus neoformans in human cerebrospinal fluid.
      aug:
        au:
          al Jalali, Valentin
          Sauermann, Robert
          Eberl, Sabine
          Zeitlinger, Markus
        affil: Department of Clinical Pharmacology, Vienna University Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
      sug:
        subj:
          Voriconazole Pharmacodynamics
          Amphotericin B Pharmacodynamics
          Candida Drug Effects
          Candida Albicans Drug Effects
          Cryptococcus Drug Effects
          Voriconazole Cerebrospinal Fluid
          Amphotericin B Cerebrospinal Fluid
          Culture Media
          Human
          In Vitro Studies
          Biochemical Phenomena
          Antibiotics Therapeutic Use
          Voriconazole Therapeutic Use
          Amphotericin B Therapeutic Use
          Central Nervous System Fungal Infections Drug Therapy
      ab: Purpose: Fungal central nervous system (CNS) infections show a high mortality rate and only a few antifungal agents are available to treat these infections. We hypothesize that the different biochemical properties of human cerebrospinal fluid (CSF) compared to the standard growth medium lead to the altered activity of antifungal agents in CSF. We investigated the in vitro activity of two of these agents, i.e., amphotericin B (AmB) and voriconazole (VOR), against three different fungi in CSF in comparison to sabouraud-dextrose broth (SDB). Methods: CSF samples from patients who did not receive any antibiotics were collected. Time-kill curves were performed in CSF and SDB using static antibiotic concentrations of AmB and VOR against ATCC strains of Candida albicans, Candida krusei, and Cryptococcus neoformans. Results: In our experiments, both AmB and VOR showed superior activity in SDB compared to CSF. Nevertheless, AmB achieved fungicidal activity in CSF after 24 h against all test strains. Voriconazole only achieved fungistatic activity against C. albicans and C. neoformans in CSF. Conclusions: In summary, our data demonstrate that growth of fungal pathogens but even more importantly activity of antifungal agents against Candida and Cryptococcus species can differ significantly in CSF compared to the standard growth medium. Both findings should be taken into consideration when applying PK/PD simulations to fungal infections of the CNS.
      pubtype: Academic Journal
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        research
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      ougenre: Article
    language: English
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