In Vitro Activities of Terbinafine against Cutaneous Isolates ofCandida albicansand Other Pathogenic Yeasts

Antimicrobial Agents and Chemotherapy - Tập 42 Số 5 - Trang 1057-1061 - 1998
Neil S. Ryder1, Sonja Wagner1, Ingrid Leitner1
1Novartis Research Institute, A-1235 Vienna, Austria

Tóm tắt

ABSTRACTTerbinafine is active in vitro against a wide range of pathogenic fungi, including dermatophytes, molds, dimorphic fungi, and some yeasts, but earlier studies indicated that the drug had little activity againstCandida albicans. In contrast, clinical studies have shown topical and oral terbinafine to be active in cutaneous candidiasis andCandidanail infections. In order to define the anti-Candidaactivity of terbinafine, we tested the drug against 350 fresh clinical isolates and additional strains by using a broth dilution assay standardized according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS) M27-A assay. Terbinafine was found to have an MIC of 1 μg/ml for referenceC. albicansstrains. For 259 clinical isolates, the MIC at which 50% of the isolates are inhibited (MIC50) of terbinafine was 1 μg/ml (fluconazole, 0.5 μg/ml), and the MIC90was 4 μg/ml (fluconazole, 1 μg/ml). Terbinafine was highly active againstCandida parapsilosis(MIC90, 0.125 μg/ml) and showed potentially interesting activity against isolates ofCandida dubliniensis,Candida guilliermondii,Candida humicola, andCandida lusitaniae. It was not active against theCandida glabrata,Candida krusei, andCandida tropicalisisolates in this assay.Cryptococcus laurentiiandCryptococcus neoformanswere highly susceptible to terbinafine, with MICs of 0.06 to 0.25 μg/ml. The NCCLS macrodilution assay provides reproducible in vitro data for terbinafine againstCandidaand other yeasts. The MICs forC. albicansandC. parapsilosisare compatible with the known clinical efficacy of terbinafine in cutaneous infections, while the clinical relevance of its activities against the other species has yet to be determined.

Từ khóa


Tài liệu tham khảo

Alexander B. D. Perfect J. R. Antifungal resistance trends towards the year 2000—implications for therapy and new approaches. Drugs 54 1997 657 678

Balfour J. A. Faulds D. Terbinafine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial mycoses. Drugs 43 1992 259 284

Clayton Y. M. 1994. Relevance of broad-spectrum and fungicidal activity of antifungals in the treatment of dermatomycoses. Br. J. Dermatol. 130 (Suppl. 43.) : 7–8.

Evans E. G. V. The clinical efficacy of terbinafine in the treatment of fungal infections of the skin. Rev. Contemp. Pharmacother. 8 1997 325 341

Faergemann J. Zehender H. Denouel J. Millerioux L. Levels of terbinafine in plasma, stratum-corneum, dermis-epidermis (without stratum-corneum), sebum, hair and nails during and after 250 mg terbinafine orally once per day for 4 weeks. Acta Dermato-Venereol. 73 1993 305 309

Girmenia C. Martino P. De Bernardis F. Gentile G. Boccanera M. Monaco M. Antonucci G. Cassone A. Rising incidence of Candida parapsilosis fungemia in patients with hematologic malignancies: clinical aspects, predisposing factors, and differential pathogenicity of the causative strains. Clin. Infect. Dis. 23 1996 506 514

Hiratani T. Asagi Y. Yamaguchi H. Evaluation of in vitro antimycotic activity of terbinafine, a new allylamine agent. Jpn. J. Med. Mycol. 32 1991 323 332

Jones T. C. 1990. Treatment of dermatomycoses with topically applied allylamines: naftifine and terbinafine. J. Dermatol. Treat. 1 (Suppl. 2) : 29–32.

Jung E. G. Haas P. J. Brautigam M. Weidinger G. Systemic treatment of skin candidosis: a randomized comparison of terbinafine and ketoconazole. Mycoses 37 1994 361 365

Kagawa S. Clinical efficacy of terbinafine in 629 Japanese patients with dermatomycosis. Clin. Exp. Dermatol. 14 1989 114 115

10.1016/S0163-7258(97)00094-6

10.1016/S0924-8579(96)00328-7

Marichal P. Gorrens J. Coene M. C. Le Jeune L. Vanden Bossche H. Origin of differences in susceptibility of Candida krusei to azole antifungal agents. Mycoses 38 1995 111 117

10.1128/jcm.26.5.950-953.1988

Nandwani R. A. Parnell M. Youle C. J. N. Lacey E. G. V. Evans J. Midgley J. Cartledge and D. A. Hawkins. 1996. Use of terbinafine in HIV-positive subjects: pilot studies in onychomycosis and oral candidiasis. Br. J. Dermatol. 134 (Suppl. 46) : 22–24.

National Committee for Clinical Laboratory Standards Reference method for broth dilution antifungal susceptibility testing of yeasts. Approved standard. NCCLS document M27-A. 1997 National Committee for Clinical Laboratory Standards Wayne Pa

Nolting S. M. Brautigam and G. Weidinger. 1994. Terbinafine in onychomycosis with involvement by non-dermatophytic fungi. Br. J. Dermatol. 130 (Suppl. 43) : 16–21.

Odds F. C. 1994. Pathogenesis of Candida infections. J. Am. Acad. Dermatol. 31 (Suppl.) : S2–S5.

10.1128/AAC.31.9.1365

10.1093/clinids/24.2.235

10.1128/AAC.39.1.1

10.1128/AAC.27.2.252

Ryder N. S. 1992. Terbinafine: mode of action and properties of the squalene epoxidase inhibition. Br. J. Dermatol. 126 (Suppl. 39) : 2–7.

Ryder N. S. Dupont M.-C. Inhibition of squalene epoxidase by allylamine antimycotic compounds: a comparative study of the fungal and mammalian enzymes. Biochem. J. 230 1985 765 770

Ryder N. S. Favre B. Antifungal activity and mechanism of action of terbinafine. Rev. Contemp. Pharmacother. 8 1997 275 287

Ryder N. S. Mieth H. Allylamine antifungal drugs. Curr. Top. Med. Mycol. 4 1992 158 188

10.1128/AAC.40.10.2300

10.1099/00221287-143-2-405

Sanz-Asenjo A. J. A. Heras-Tabernero S. Vidal-Asensi and C. Arjona-Manuel. 1997. Healing of a multidrug resistant cutaneous cryptococcosis with oral terbinafine. Australas. J. Dermatol. 38 (Suppl. 2) : 120.

Schatz F. Brautigam M. Dobrowolski E. Effendy I. Haberl H. Mensing H. Weidinger G. Stuetz A. Nail incorporation kinetics of terbinafine in onychomycosis patients. Clin. Exp. Dermatol. 20 1995 377 383

Schaude M. Ackerbauer H. Mieth H. Inhibitory effect of antifungal agents on germ tube formation in Candida albicans. Mykosen 30 1987 281 287

Segal R. Kritzman A. Cividalli L. Samra Z. David M. Treatment of Candida nail infection with terbinafine. J. Am. Acad. Dermatol. 35 1996 958 961

Shadomy S. Espinell-Ingroff A. Gebhart R. J. In vitro studies with SF 86-327, a new orally active allylamine derivative. Sabouraudia 23 1985 125 132

Villars V. and T. C. Jones. 1990. Present status of the efficacy and tolerability of terbinafine (Lamisil) used systemically in the treatment of dermatomycoses of skin and nails. J. Dermatol. Treat. 1 (Suppl. 2) : 33–38.

Villars V. V. and T. C. Jones. 1992. Special features of the clinical use of oral terbinafine in the treatment of fungal diseases. Br. J. Dermatol. 129 (Suppl. 39) : 61–69.

Weems J. J. Candida parapsilosis: epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility. Clin. Infect. Dis. 14 1992 756 766

Zaias N. 1997. Candida : a review of clinical experience with Lamisil(R). Dermatology 194 (Suppl. 1) : 10–13.

Thông tin
Thông tin xuất bản

Antimicrobial Agents and Chemotherapy

Tập 42 Số 5

1057-1061

Thông tin tác giả