Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If you need an accessible version of this item please contact JSTOR User Support

Is Antifungal Susceptibility Testing Useful in Guiding Fluconazole Therapy?

Mahmoud A. Ghannoum
Clinical Infectious Diseases
Vol. 22, Supplement 2. Focus on Fungal Infections 5 (May, 1996), pp. S161-S165
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4459460
Page Count: 5
  • Download ($42.00)
  • Subscribe ($19.50)
  • Cite this Item
If you need an accessible version of this item please contact JSTOR User Support
Is Antifungal Susceptibility Testing Useful in Guiding Fluconazole Therapy?
Preview not available

Abstract

Recently, the National Committee for Clinical Laboratory Standards (NCCLS) subcommittee on antifungal susceptibility testing published a proposed standard for a broth macrodilution method for in vitro susceptibility testing of yeasts. The major reason for developing such a method is to predict the likely clinical and microbiological outcome of treatment. A number of studies of fluconazole have attempted to correlate in vitro minimum inhibitory concentrations (MICs) with in vivo efficacy in humans by means of a variety of methods, including the NCCLS proposed standard. These studies have clearly demonstrated that the ability to predict clinical outcome with MICs is dependent on the patient population studied. Thus, fluconazole MICs were correlated with clinical outcomes for patients with AIDS-associated oropharyngeal candidiasis. In contrast, fluconazole MICs did not correlate with clinical outcomes for patients with candidemia who did not have AIDS; these patients have numerous factors that can independently influence the response to antifungal therapy aside from the MIC. Data on patients with AIDS-associated cryptococcal meningitis from my laboratory demonstrated that the use of fluconazole MICs in conjunction with clinical variables, such as blood culture results, enhances the ability to predict treatment outcome. More investigations addressing the role of host factors in the in vitro-in vivo correlation are necessary before antifungal testing can be useful in guiding therapy.

Page Thumbnails

  • Thumbnail: Page 
S161
    S161
  • Thumbnail: Page 
S162
    S162
  • Thumbnail: Page 
S163
    S163
  • Thumbnail: Page 
S164
    S164
  • Thumbnail: Page 
S165
    S165