       Document 0457
 DOCN  M9610457
 TI    Correlation of in-vitro susceptibility test results with clinical
       response: a study of azole therapy in AIDS patients.
 DT    9601
 AU    Rodriguez-Tudela JL; Martinez-Suarez JV; Dronda F; Laguna F; Chaves F;
       Valencia E; Unidad de Micologia, Instituto de Salud Carlos III, Madrid,;
       Spain.
 SO    J Antimicrob Chemother. 1995 Jun;35(6):793-804. Unique Identifier :
       AIDSLINE MED/96047287
 AB    The in-vitro susceptibilities of 40 clinical isolates of Candida
       albicans to ketoconazole and fluconazole were determined and an attempt
       was made to correlate these data with the clinical responses of the
       patients from whom the strains were originally isolated to treatment
       with these agents. Of 40 patients with the acquired immunodeficiency
       syndrome (AIDS) with oropharyngeal and/or oesophageal candidosis, 21
       received ketoconazole and 19 fluconazole. Susceptibility testing was
       performed by a microbroth dilution method with RPMI-2% glucose medium
       according to the recommendations of the National Committee for Clinical
       Laboratory Standards; growth inhibition was estimated
       spectrophotometrically and the MIC endpoint was defined in terms of the
       IC1/2. The MICs of 236 additional strains of C. albicans, which were
       also isolated from AIDS patients, were used to establish a
       susceptibility profile for this species. On the basis of the
       susceptibility test results and the clinical responses of the 40
       patients, the following tentative breakpoints for ketoconazole and
       fluconazole are proposed: patients with infections caused by C. albicans
       strains with MICs of ketoconazole and fluconazole or < or = 0.001 and <
       or = 0.25 mg/L respectively would be expected to respond to treatment
       with these agents and isolates with MICs which meet these criteria are
       therefore classified as susceptible; patients with infections caused by
       strains with MICs of ketoconazole and fluconazole of > or = 0.06 and >
       or = 16.0 mg/L respectively would not be expected to respond to
       treatment with these agents and isolates with MICs which meet these
       criteria are therefore classified as resistant; the response of patients
       with infections caused by strains with MICs of ketoconazole and
       fluconazole of 0.003-0.03 and 0.5-8.0 mg/L respectively cannot be
       reliably predicted and isolates with MICs which fall within these ranges
       are therefore classified as being of indeterminate susceptibility. The
       present study demonstrates that the results of in-vitro susceptibility
       testing with RPMI-2% glucose broth correlate with the clinical response
       to therapy and can be used to facilitate optimal treatment in AIDS
       patients with oropharyngeal and/or oesophageal candidosis.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  Antifungal
       Agents/*PHARMACOLOGY/*THERAPEUTIC USE  Azoles/*PHARMACOLOGY/*THERAPEUTIC
       USE  Candida albicans/*DRUG EFFECTS  Candidiasis, Oral/*DRUG
       THERAPY/MICROBIOLOGY  Female  Human  Male  Microbial Sensitivity Tests
       Middle Age  Prospective Studies  Support, Non-U.S. Gov't  Treatment
       Outcome  CLINICAL TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

