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Antifungal drug combinations for Cryptococcus neoformans and Prototheca spp

S Srimuang1, C Prariyachatigul, A Chaiprasert

  • 1Research Center, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 11, 2000
PubMed

Insights

The combination of amphotericin B and rifampin effectively reduced minimal inhibitory concentrations for Cryptococcus neoformans. Amphotericin B with flucytosine showed minimal impact on susceptibility.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Antimicrobial Susceptibility Testing

Background:

  • Cryptococcus neoformans is an opportunistic fungal pathogen causing cryptococcosis.
  • Antifungal drug resistance is a growing concern in treating fungal infections.
  • Evaluating combination therapies is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To assess the in vitro synergistic effects of amphotericin B combined with flucytosine or rifampin against Cryptococcus neoformans.
  • To determine the impact of these combinations on the minimal inhibitory concentration (MIC) of amphotericin B.

Main Methods:

  • Broth dilution methods were employed to test susceptibility.
  • Seventy-one Cryptococcus neoformans and 5 Prototheca spp. isolates were analyzed.
  • In vitro susceptibility was evaluated against amphotericin B alone and in combination with flucytosine (5-FC) and rifampin.

Main Results:

  • The combination of amphotericin B and rifampin demonstrated a significant reduction in amphotericin B's MIC.
  • Amphotericin B combined with flucytosine showed little to no reduction in MIC compared to amphotericin B monotherapy.
  • Rifampin exhibited a synergistic effect when combined with amphotericin B.

Conclusions:

  • Rifampin shows promise as an adjunct therapy to amphotericin B for Cryptococcus neoformans infections.
  • Flucytosine does not appear to enhance the in vitro activity of amphotericin B against this pathogen.
  • Combination therapy with amphotericin B and rifampin warrants further investigation for clinical efficacy.

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