In vitro activities of posaconazole, ravuconazole, terbinafine, itraconazole and fluconazole against dermatophyte, yeast and non-dermatophyte species

Med Mycol. 2005 Mar;43(2):179-85. doi: 10.1080/13693780410001731583.

Abstract

The in vitro activities of two new triazole antifungal agents with broad-spectrum antifungal activity, posaconazole and ravuconazole, were compared with those of three well-established antifungal agents, terbinafine, itraconazole and fluconazole, against 184 clinical isolates. These included 129 dermatophyte isolates (twelve species), 25 yeast isolates (five species) and 28 non-dermatophyte isolates (nine species). In vitro testing was conducted using microdilution plates with RPMI 1640 and National Committee for Clinical Laboratory Standards (NCCLS) guidelines (M27-38P) were followed, except for the preparation of the dermatophyte inoculum. Both posaconazole and ravuconazole showed similar broad-spectrum activity against dermatophyte, yeast and non-dermatophyte species. Mean inhibitory concentrations (MIC) at which 90% [MIC90] of the isolates were inhibited by posaconazole and ravuconazole were 0.25 and 0.5 microg/ml for dermatophytes, 0.5 and 0.25 microg/ml for yeasts, and >4 and 8 microg/ml for non-dermatophytes. The MIC ranges against Trichophyton (six species), Microsporum (five species) and Epidermophyton flocossum were: posaconazole (0.007-1.0/0.007-0.25/0.007-1.0 microg/ml), ravuconazole (0.015-8.0/0.015-1.0/0.015-1.0 microg/ml), itraconazole (0.015- >8.0/0.015-0.5/ 0.015-8.0 microg/ml), fluconazole (0.125- >64.0/4.0 >64.0/0.5-64.0 microg/ml) and terbinafine (0.003 >2.0/0.007-2.0/0.007 >2.0 microg/ml). Overall ranking of the antifungal activity of the five antifungal agents was: terbinafine > posaconazole > ravuconazole > itraconazole > fluconazole, for dermatophytes; ravuconazole > posaconazole > itraconazole > fluconazole > terbinafine, against yeasts; and posaconazole > ravuconazole > terbinafine > itraconazole > fluconazole, for non-dermatophytes.

Publication types

  • Comparative Study

MeSH terms

  • Antifungal Agents / pharmacology*
  • Arthrodermataceae / drug effects*
  • Fluconazole / pharmacology*
  • Fungi / drug effects*
  • Fungi / isolation & purification
  • Humans
  • Itraconazole / pharmacology*
  • Microbial Sensitivity Tests
  • Mycoses / microbiology
  • Naphthalenes / pharmacology*
  • Terbinafine
  • Thiazoles / pharmacology*
  • Triazoles / pharmacology*
  • Yeasts / drug effects
  • Yeasts / isolation & purification

Substances

  • Antifungal Agents
  • Naphthalenes
  • Thiazoles
  • Triazoles
  • Itraconazole
  • posaconazole
  • Fluconazole
  • ER 30346
  • Terbinafine