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Published on: October 21, 2010
Evaluation of fluconazole, itraconazole, and voriconazole activity on Candida albicans: A case control study
Agung Dewi Sekar Langit Partha1, Agung Dwi Wahyu Widodo2, Pepy Dwi Endraswari2
1Study Program of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Background:
Azole antifungals are the most commonly used antifungals. The high use of azoles for long-term therapy and prophylaxis is prone to cause resistance. Thus, it is necessary to evaluate the antifungal activity against Candida albicans.
Objectives:
Analyzing the comparison of antifungal exposure on the time-kill curve to Candida albicans.
Method:
A case-control study was conducted with a posttest control group design. This study used Candida albicans clinical and ATCC isolates exposed to antifungal solutions with 1 ×, 4 ×, and 16 × minimum inhibitory concentrations (MIC). Antibiotics used included fluconazole, itraconazole, and voriconazole. Candida albicans isolates were incubated with MIC, and the number of colonies was counted at 0, 2, 4, 8, 12, 24, and 48 h. The number of colonies that grew every hour of observation was included in the time-kill curve. The data were then analyzed using an ANOVA test with p <0.05.
Results:
The antifungals (fluconazole, itraconazole, and voriconazole) showed fungistatic activity against Candida albicans clinical and ATCC isolates. There was a significant comparison between the antifungal group and the control group at 12, 24, and 48 h. The most significant difference between antifungal and control group was found at 24 h where fluconazole had 95% CI = 0.807-2.061 (p <0.001), itraconazole 95% CI = 0.722-1.976 (p <0.001), and voriconazole CI 95% = 0.807-2.062 (p <0.001).
Conclusion:
Fluconazole, itraconazole, and voriconazole were effective in inhibiting the growth of Candida albicans. Maximum inhibition in vitro occurs after 12 h of antifungal exposure.
Insights
Azole antifungals like fluconazole, itraconazole, and voriconazole effectively inhibit Candida albicans growth. Maximum antifungal activity in vitro was observed after 12 hours of exposure.
Area of Science:
- Mycology
- Antimicrobial Resistance
- Pharmacology
Background:
- Azole antifungals are widely used for long-term therapy and prophylaxis.
- High usage of azoles can lead to antifungal resistance.
- Evaluating antifungal activity against Candida albicans is crucial.
Purpose of the Study:
- To analyze the antifungal activity of azoles against Candida albicans.
- To compare the time-kill curve of Candida albicans exposed to different antifungal concentrations.
Main Methods:
- A case-control study with a posttest control group design was employed.
- Candida albicans isolates (clinical and ATCC) were exposed to fluconazole, itraconazole, and voriconazole at 1x, 4x, and 16x MIC.
- Colony counts were performed at various time points (0-48h) to generate time-kill curves and analyzed using ANOVA.
Main Results:
- Fluconazole, itraconazole, and voriconazole demonstrated fungistatic activity against Candida albicans.
- A significant difference in growth was observed between antifungal-treated groups and the control group from 12 hours onwards.
- The most significant inhibition was noted at 24 hours, with p < 0.001 for all tested azoles.
Conclusions:
- Fluconazole, itraconazole, and voriconazole are effective in inhibiting Candida albicans growth.
- In vitro maximum inhibition of Candida albicans by these azoles is achieved after 12 hours of exposure.
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