Fluconazole vs amphotericin B: "in vitro" comparative evaluation of the minimal inhibitory concentration (MIC) against yeasts isolated from AIDS patients.

Fluconazole, a novel triazole antifungal drug, holds promise as a significant advance in the management of human fungal diseases. This new drug can be both orally and parenterally administered and is reported to be less toxic than other antifungal agents. The Authors studied the in vitro susceptibility of yeasts isolated from AIDS patients to this antimycotic drug, in order to evaluate if fluconazole's MICs were comparable to those of amphotericin B. A sample of 200 yeast strains (100 C.albicans, 20 C.parapsilosis, 20 C.tropicalis, 8 C.guilliermondii, 6 C.krusei, 6 C.pseudotropicalis, 24 T.glabrata and 16 Cr.neoformans) was tested. The results show an average MIC for amphotericin B (MIC90: 3.12 micrograms/ml) ten-fold lower than for fluconazole (MIC90: 100 micrograms/ml). However, C.albicans and Cr.neoformans presented the same MIC value (3.12 micrograms/ml) both for fluconazole and for amphotericin B, suggesting that fluconazole could represent a valid alternative to amphotericin B in the treatment of fungal infections caused by these two agents.