In vitro interactions between antifungals and methotrexate against Aspergillus spp

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Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds

Published on: February 14, 2018

Jianxun Yang1, Zhe Wan, Xiaohong Wang

  • 1Department of Dermatology, Research Center of Medical Mycology, Peking University First Hospital, Peking University, No. 8 Xishiku St., West District, 100034, Beijing, China.

Mycopathologia
|June 24, 2009
PubMed

Insights

This study found that combining terbinafine with methotrexate showed synergistic effects against Aspergillus infections in vitro, offering a potential new treatment for immunocompromised patients. Further clinical research is recommended.

Area of Science:

  • Mycology
  • Pharmacology
  • Oncology

Background:

  • Methotrexate is a key treatment for osteosarcoma, lymphoma, and leukemia.
  • Immunocompromised patients on methotrexate are susceptible to opportunistic Aspergillus infections.

Purpose of the Study:

  • To investigate the in vitro interactions between methotrexate and common antifungal agents against Aspergillus species.
  • To identify potential synergistic or antagonistic effects for improved treatment strategies.

Main Methods:

  • Microdilution checkerboard and disk diffusion assays were used.
  • Twenty-three clinical isolates of Aspergillus spp. were tested.
  • Interactions with voriconazole, itraconazole, terbinafine, and amphotericin B were evaluated.

Main Results:

  • Terbinafine and methotrexate demonstrated synergy against 60.9% of Aspergillus strains.
  • Methotrexate showed no significant interaction with itraconazole or amphotericin B.
  • Voriconazole showed indifference or antagonism when combined with methotrexate.

Conclusions:

  • The combination of terbinafine and methotrexate exhibits promising synergistic activity against Aspergillus in vitro.
  • This combination warrants further investigation in clinical settings for immunocompromised patients.
  • Optimizing antifungal therapy alongside methotrexate is crucial for managing opportunistic infections.

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