Comparison of azoles against aspergilli in vitro and in an experimental model of pulmonary aspergillosis Journal Article


Authors: Schmitt, H. J.; Edwards, F.; Andrade, J.; Niki, Y.; Armstrong, D.
Article Title: Comparison of azoles against aspergilli in vitro and in an experimental model of pulmonary aspergillosis
Abstract: Current treatment modalities for bronchopulmonary aspergillosis are not very satisfying. We determined the in vitro activity of recently available azoles against Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger Subsequently, these agents were evaluated in an animal model of bronchopulmonary aspergillosis using A. fumigatus as test organism. In vitro, detectable activity was only found for itraconazole (all minimal inhibitory concentrations, MICs, less-than-or-equal-to 3.2-mu-g/ml). The MICs for SCH39304 were greater-than-or-equal-to 12.8-mu-g/ml and greater-than-or-equal-to 25.6-mu-g/ml for ketoconazole and fluconazole. In vivo, amphotericin B was the most active agent tested, and SCH39304 was the most active azole in terms of survival and reduction in lung weight, followed by itraconazole. Ketoconazole and fluconazole did not improve survival nor reduce the lung weight of infected animals. We conclude, (1) that in vitro activity of azoles against aspergilli does not always correlate with in vivo activity; (2) that in vivo, SCH39304 was the most active azole tested, followed by itraconazole; (3) that for those agents for which data about effectiveness in human pulmonary aspergillosis are available (amphotericin B, ketoconazole, itraconazole) antifungal activity in our model corresponds to activity as seen in human beings, and (4) that SCH39304 and itraconazole are rational choices for clinical trials in human pulmonary aspergillosis.
Keywords: leukemia; therapy; antifungal; azoles; liposomes; itraconazole; triazole; invasive aspergillosis; susceptibility; invasive pulmonary aspergillosis; agents; amphotericin-b; aspergillus spp; experimental murine aspergillosis; antifungal susceptibility tests
Journal Title: Chemotherapy
Volume: 38
Issue: 2
ISSN: 0009-3157
Publisher: Karger  
Date Published: 1992-01-01
Start Page: 118
End Page: 126
Language: English
ACCESSION: WOS:A1992HW42900007
DOI: 10.1159/000238951
PROVIDER: wos
PUBMED: 1317280
Notes: Source: Wos
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  1. Donald Armstrong
    240 Armstrong
  2. Fitzroy F Edwards
    23 Edwards