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Related Experiment Videos

Decrease in Candida albicans strains with reduced susceptibility to fluconazole following changes in prescribing

J Lopez1, C Pernot, S Aho

  • 1Department of Parasitology and Mycology, University Hospital and School of Medicine, Dijon, France.

The Journal of Hospital Infection
|June 29, 2001
PubMed
Summary
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Prolonged, low-dose fluconazole use, not total amount, increased resistance in Candida albicans. Reducing intermittent or prolonged low-dose prescriptions restored normal fungal ecology.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Antifungal resistance is a growing concern in clinical settings.
  • Fluconazole is a widely used antifungal agent.
  • Understanding prescribing patterns is crucial for managing antifungal resistance.

Purpose of the Study:

  • To identify prescribing policies influencing fluconazole resistance.
  • To investigate the relationship between fluconazole exposure and Candida albicans susceptibility.
  • To compare fluconazole utilization and resistance in infectious diseases and clinical haematology units.

Main Methods:

  • Assessed fluconazole exposure using the penetration index (PI).
  • Evaluated fluconazole utilization for different dosing regimens (50 mg vs. 200 mg).

Related Experiment Videos

  • Determined in vitro susceptibility of Candida albicans isolates using broth microdilution (IC50).

    • Main Results:

    • In infectious diseases, a decline in PI for low-dose fluconazole correlated with increased total fluconazole use.
    • Candida albicans IC50 significantly decreased in infectious diseases, indicating increased resistance.
    • No significant changes in IC50 or PI were observed in clinical haematology.

    Conclusions:

    • Prolonged or repeated exposure to low-dose fluconazole, rather than cumulative use, was linked to fluconazole resistance.
    • Reducing low-dose, prolonged, or intermittent fluconazole prescriptions led to a restoration of normal fungal ecology.
    • These findings highlight the importance of specific prescribing strategies in controlling antifungal resistance.