Differential fungicidal activities of amphotericin B and voriconazole against Aspergillus species determined by microbroth methodology

Antimicrob Agents Chemother. 2007 Sep;51(9):3329-37. doi: 10.1128/AAC.00345-07. Epub 2007 Jun 18.

Abstract

Antifungal agents may differ in their fungicidal activities against Aspergillus spp. In order to compare the fungicidal activities of voriconazole and amphotericin B against 40 isolates of Aspergillus fumigatus, A. flavus, and A. terreus, we developed a new microbroth colorimetric method for assessing fungicidal activities and determining minimal fungicidal concentrations (MFCs). This methodology follows the antifungal susceptibility testing reference method M-38A for MIC determination. After drug removal and addition of fresh medium, growth of viable conidia adhering to the bottoms of the microtitration wells was assessed by a colorimetric assay of metabolic activity after 24 h of incubation. The new method was faster (six times), reproducible (92 to 97%), and in agreement with culture-based MFCs (91 to 100%). Differential fungicidal activities of voriconazole and amphotericin B were found among the three Aspergillus species, with A. fumigatus and A. flavus having the lowest (1 and 2 mg/liter, respectively) and A. terreus the highest (>16 mg/liter) median amphotericin B MFCs; A. flavus had a lower median voriconazole MFC (4 mg/liter) than the other species (>8 mg/liter; P < 0.05). Amphotericin B was fungicidal (MFC/MIC </= 4) against all A. fumigatus and A. flavus isolates but no A. terreus isolates, whereas voriconazole was fungicidal against 82% of A. flavus isolates and fungistatic (MFC/MIC > 4) against 94% of A. fumigatus and 84% of A. terreus isolates. The new methodology revealed a concentration-dependent sigmoid pattern of fungicidal effects, indicating that fungicidal activity is not an all-or-nothing phenomenon and that some degree of fungicidal action can be found even for agents considered fungistatic based on the MFC/MIC ratio.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Amphotericin B / pharmacology*
  • Antifungal Agents / pharmacology*
  • Aspergillus / drug effects*
  • Aspergillus / growth & development
  • Colony Count, Microbial
  • Colorimetry
  • Culture Media
  • Microbial Sensitivity Tests / methods*
  • Pyrimidines / pharmacology*
  • Quality Control
  • Regression Analysis
  • Reproducibility of Results
  • Species Specificity
  • Spores, Fungal / drug effects
  • Tetrazolium Salts
  • Triazoles / pharmacology*
  • Vitamin K 3 / pharmacology
  • Voriconazole

Substances

  • Antifungal Agents
  • Culture Media
  • Pyrimidines
  • Tetrazolium Salts
  • Triazoles
  • 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-((phenylamino)carbonyl)-2H-tetrazolium hydroxide
  • Vitamin K 3
  • Amphotericin B
  • Voriconazole