ArticleAntimicrobial agents and chemotherapy2000
Correlation of fluconazole MICs with clinical outcome in cryptococcal infection.
Article in Antimicrobial agents and chemotherapy, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 1 of them a synthesis that pooled it.
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Who cites it
56 citing papers in PubMed, 1 synthesis or guideline pooled it, 170 citations in OpenAlex.
- Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2010Guideline
- Increased Antifungal Drug Resistance in Clinical Isolates of Cryptococcus neoformans in Uganda.Antimicrobial agents and chemotherapy · 2015Trial
- Effect of rifampicin on the pharmacokinetics of fluconazole in patients with AIDS.Clinical pharmacokinetics · 2004Trial
- InFuture microbiology · 2025Article
- [Cryptococcus albidus, Naganishia albida, primary skin infection, first case reported in Mexico].Revista medica del Instituto Mexicano del Seguro Social · 2025Article
- Comparative evaluation of sensititre YeastOne and VITEK2 antifungal susceptibility tests with CLSI broth microdilution method of clinicalMicrobiology spectrum · 2025Article
- Antifungal Resistance in Cryptococcal Infections.Pathogens (Basel, Switzerland) · 2024Review
- Methods for Antifungal Susceptibility Testing of theJournal of fungi (Basel, Switzerland) · 2023Review
- Exposure ofPathogens (Basel, Switzerland) · 2023Article
- Lack of Association between YEASTONE Antifungal Susceptibility Tests and Clinical Outcomes ofJournal of fungi (Basel, Switzerland) · 2023Article
- Lack of Association between Fluconazole Susceptibility andJournal of fungi (Basel, Switzerland) · 2022Article
- Early clinical and microbiological predictors of outcome in hospitalized patients with cryptococcal meningitis.BMC infectious diseases · 2022Article
- Antifungal Susceptibility Testing: A Primer for Clinicians.Open forum infectious diseases · 2021Review
- The need for environmental surveillance to understand the ecology, epidemiology and impact of Cryptococcus infection in Africa.FEMS microbiology ecology · 2021Review
- Cryptococcal Meningitis in an HIV-Negative Puerperal Woman.Case reports in infectious diseases · 2021Article
- An Elderly Patient with Pulmonary Cryptococcosis with Mediastinal Lymphadenopathy Who Was Successfully Treated with Amphotericin B and Flucytosine.Internal medicine (Tokyo, Japan) · 2020Article
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- Article
- Cryptococcus genetic diversity and mixed infections in Ivorian HIV patients: A follow up study.PLoS neglected tropical diseases · 2019Article
- Minimum Inhibitory Concentration Distribution of Fluconazole against Cryptococcus Species and the Fluconazole Exposure Prediction Model.Open forum infectious diseases · 2019Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We have correlated the in vitro results of testing the susceptibility of Cryptococcus neoformans to fluconazole with the clinical outcome after fluconazole maintenance therapy in patients with AIDS-associated cryptococcal disease. A total of 28 isolates of C. neoformans from 25 patients (24 AIDS patients) were tested. The MICs were determined by the broth microdilution technique by following the modified guidelines described in National Committee for Clinical Standards (NCCLS) document M27-A, e.g., use of yeast nitrogen base medium and a final inoculum of 10(4) CFU/ml. The fluconazole MIC at which 50% of isolates are inhibited (MIC(50)) and MIC(90), obtained spectrophotometrically after 48 h of incubation, were 4 and 16 microg/ml, respectively. Of the 25 patients studied, 4 died of active cryptococcal disease and 2 died of other causes. Therapeutic failure was observed in five patients who were infected with isolates for which fluconazole MICs were > or =16 microg/ml. Four of these patients had previously had oropharyngeal candidiasis (OPC); three had previously had episodes of cryptococcal infection, and all five treatment failure patients had high cryptococcal antigen titers in either serum or cerebrospinal fluid (titers, >1:4,000). Although 14 of the 18 patients who responded to fluconazole therapy had previously had OPC infections, they each had only a single episode of cryptococcal infection. It appears that the clinical outcome after fluconazole maintenance therapy may be better when the infecting C. neoformans strain is inhibited by lower concentrations of fluconazole for eradication (MICs, <16 microg/ml) than when the patients are infected with strains that require higher fluconazole concentrations (MICs, > or =16 microg/ml). These findings also suggest that the MICs determined by the modified NCCLS microdilution method can be potential predictors of the clinical response to fluconazole therapy and may aid in the identification of patients who will not respond to fluconazole therapy.
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