Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-06-05T10:11:37.027Z Has data issue: false hasContentIssue false
  • English
  • Français

In vitro activities of fluconazole, itraconazole and voriconazole against otomycotic fungal pathogens

Published online by Cambridge University Press:  20 May 2009

G Yenişehirli ,
Y Bulut ,
M Güven  and
E Günday
G Yenişehirli*
Affiliation:
Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
Y Bulut
Affiliation:
Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
M Güven
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
E Günday
Affiliation:
Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
*
Address for correspondence: Dr Gülgün Yenişehirli, Gaziosmanpaşa University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, 60100 Tokat, Turkey. Fax: +90 356 2133176 E-mail: gulguny@gop.edu.tr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the causative pathogens of otomycosis, and to evaluate the in vitro activity of antifungal agents against these pathogens.

Materials and methods:

A total of 96 fungal isolate were taken from 92 patients suspected of otomycosis. The in vitro activity of fluconazole, itraconazole and voriconazole against otomycotic pathogens was tested using the E-test method.

Results:

The most common pathogen was Aspergillus fumigatus (40.6 per cent), followed by A niger (35.4 per cent), A flavus (12.5 per cent) and Candida albicans (11.5 per cent). All Aspergillus species were found to be resistant to fluconazole (minimum inhibitory concentration ≥256 µg/ml). The mean minimum inhibitory concentrations of voriconazole for A fumigatus, A niger, A flavus and C albicans were significantly lower than those of itraconazole for the same pathogens.

Conclusion:

This study found that the most common otomycotic fungal pathogen was A fumigatus, and that voriconazole had more potent in vitro activity than itraconazole against all Aspergillus species as well as against C albicans.

Keywords

Otitis ExternaFungus DiseasesAntifungal Agents
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 9 , September 2009 , pp. 978 - 981
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Kaur, R, Mittal, N, Kakkar, M, Aggarwal, AK, Mathur, MD. Otomycosis: a clinicomycologic study. Ear Nose Throat J 2000;79:606–9CrossRefGoogle ScholarPubMed
2 Lucente, FE. Fungal infections of the external ear. Otolaryngol Clin North Am 1993;26:995–1006CrossRefGoogle ScholarPubMed
3 Vennewald, I, Wollina, U. Cutaneous infections due to opportunistic molds: uncommon presentations. Clin Dermatol 2005;23:565–71CrossRefGoogle ScholarPubMed
4 Denning, DW, Venkateswarlu, K, Oakley, KL, Anderson, MJ, Manning, NJ, Stevens, DA et al. Itraconazole resistance in Aspergillus fumigatus. Antimicrob Agents Chemother 1997;41:1364–8CrossRefGoogle ScholarPubMed
5 Denning, DW, Radford, SA, Oakley, KL, Hall, L, Johnson, EM, Warnock, DW. Correlation between in-vitro susceptibility testing to itraconazole and in-vivo outcome of Aspergillus fumigatus infection. J Antimicrob Chemother 1997;40:401–14CrossRefGoogle ScholarPubMed
6 Rex, JH, Rinaldi, MG, Pfaller, MA. Resistance of Candida species to fluconazole. Antimicrob Agents Chemother 1995;39:1–8CrossRefGoogle ScholarPubMed
7 Kombila, M, Gomez de Diaz, M, de Bievre, C, Crepet, G, Debrie, JC, Belembaogo, E et al. Fungal otitis in Libreville. Study of 83 cases. Bull Soc Pathol Exot Filiales 1989;82:201–7Google ScholarPubMed
8 Ozcan, KM, Ozcan, M, Karaarslan, A, Karaarslan, F. Otomycosis in Turkey: predisposing factors, aetiology and therapy. J Laryngol Otol 2003;117:39–42CrossRefGoogle ScholarPubMed
9 Kaya, AD, Kiraz, N. In vitro susceptibilities of Aspergillus spp. causing otomycosis to amphotericin B, voriconazole and itraconazole. Mycoses 2007;50:447–50CrossRefGoogle ScholarPubMed
10 Phillips, P, Bryce, G, Shepherd, J, Mintz, D. Invasive external otitis caused by Aspergillus. Rev Infect Dis 1990;12:277–81CrossRefGoogle ScholarPubMed
11 Stodulski, D, Kowalska, B, Stankiewicz, C. Otogenic skull base osteomyelitis caused by invasive fungal infection. Case report and literature review. Eur Arch Otorhinolaryngol 2006;263:1070–6CrossRefGoogle ScholarPubMed
12 National Committee for Clinical Laboratory Standards. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi. Approved standard. NCCLS Document M38-A. Villanova, Pennsylvania: Clinical and Laboratory Standards Institute, 2002Google Scholar
13 Espinel-Ingroff, A, Rezusta, A. E-test method for testing susceptibilities of Aspergillus spp. to the new triazoles voriconazole and posaconazole and to established antifungal agents: comparison with NCCLS broth microdilution method. J Clin Microbiol 2002;40:2101–7CrossRefGoogle Scholar
14 Pfaller, JB, Messer, SA, Hollis, RJ, Diekema, DJ, Pfaller, MA. In vitro susceptibility testing of Aspergillus spp.: comparison of E-test and reference microdilution methods for determining voriconazole and itraconazole MICs. J Clin Microbiol 2003;41:1126–9CrossRefGoogle Scholar
15 Pfaller, MA, Diekema, DJ, Messer, SA, Boyken, L, Hollis, RJ. Activities of fluconazole and voriconazole against 1,586 recent clinical isolates of Candida species determined by Broth microdilution, disk diffusion, and E-test methods: report from the ARTEMIS Global Antifungal Susceptibility Program, 2001. J Clin Microbiol 2003;41:1440–6CrossRefGoogle Scholar
16 Sheehan, DJ, Hitchcock, CA, Sibley, CM. Current and emerging azole antifungal agents. Clin Microbiol Rev 1999;12:40–79CrossRefGoogle ScholarPubMed
17 Pfaller, MA, Messer, SA, Hollis, RJ, Jones, RN, SENTRY Participants Group. Antifungal activities of posaconazole, ravuconazole, and voriconazole compared to those of itraconazole and amphotericin B against 239 clinical isolates of Aspergillus spp. and other filamentous fungi: report from SENTRY Antimicrobial Surveillance Program, 2000. Antimicrob Agents Chemother 2002;46:1032–7CrossRefGoogle ScholarPubMed
18 Messer, SA, Jones, RN, Fritsche, TR. International surveillance of Candida spp. and Aspergillus spp.: report from the SENTRY Antimicrobial Surveillance Program (2003). J Clin Microbiol 2006;44:1782–7CrossRefGoogle ScholarPubMed
19 Verweij, PE, Te Dorsthorst, DT, Rijs, AJ, De Vries-Hospers, HG, Meis, JF. Nationwide survey of in vitro activities of itraconazole and voriconazole against clinical Aspergillus fumigatus isolates cultured between 1945 and 1998. J Clin Microbiol 2002;40:2648–50CrossRefGoogle ScholarPubMed
20 Dannaoui, E, Persat, F, Monier, MF, Borel, E, Piens, MA, Picot, S. In vitro susceptibility of Aspergillus spp. isolates to amphotericin B and itraconazole. J Antimicrob Chemother 1999;44:553–5CrossRefGoogle ScholarPubMed
21 Pfaller, MA, Boyken, L, Hollis, RJ, Messer, SA, Tendolkar, S, Diekema, DJ. In vitro susceptibilities of clinical isolates of Candida species, Cryptococcus neoformans, and Aspergillus species to itraconazole: global survey of 9,359 isolates tested by clinical and laboratory standards institute broth microdilution methods. J Clin Microbiol 2005;43:3807–10CrossRefGoogle Scholar
22 Mallié, M, Bastide, JM, Blancard, A, Bonnin, A, Bretagne, S, Cambon, M et al. In vitro susceptibility testing of Candida and Aspergillus spp. to voriconazole and other antifungal agents using E-test: results of a French multicentre study. Int J Antimicrob Agents 2005;25:321–8CrossRefGoogle Scholar