Susceptibility testing of fungi and correlation with clinical outcome

With recent developments in the field of mycology such as increased incidence of fungal infections, the introduction of newer, safer antifungals, and the emergence of resistance, the need for clinically relevant antifungal susceptibility testing methods is obvious. Studies performed over the past decade have allowed the NCCLS Subcommittee on Antifungal Testing to achieve consensus on a new standardized broth dilution method for in vitro susceptibility testing of yeast (NCCLS M27). This review summarizes the studies correlating in vitro susceptibility testing and clinical outcome, presents tentative breakpoints for fluconazole and itraconazole, and emphasizes the utility of in vitro testing in the management of patients with candidiasis.