ArticleAntimicrobial agents and chemotherapy2011
Multilaboratory testing of two-drug combinations of antifungals against Candida albicans, Candida glabrata, and Candida parapsilosis.
Article in Antimicrobial agents and chemotherapy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 48 citations in OpenAlex.
- Fast detection of synergy and antagonism in antifungal combinations used against Candida albicans clinical isolates.Scientific reports · 2025Article
- The tell-tale hearts: Donor-derived invasive fungal infections among orthotopic heart transplant recipients.Medical mycology case reports · 2025Article
- Assessing the physiological properties of baker's yeast based on single-cell Raman spectrum technology.Synthetic and systems biotechnology · 2025Article
- CAF to the Rescue! Potential and Challenges of Combination Antifungal Therapy for Reducing Morbidity and Mortality in Hospitalized Patients With Serious Fungal Infections.Open forum infectious diseases · 2024Review
- Multicenter Collaborative Study of the Interaction of Antifungal Combinations againstJournal of fungi (Basel, Switzerland) · 2022Article
- A computer vision chemometric-assisted approach to access pH and glucose influence on susceptibility of Candida pathogenic strains.Archives of microbiology · 2022Article
- Candida auris Pan-Drug-Resistant to Four Classes of Antifungal Agents.Antimicrobial agents and chemotherapy · 2022Article
- Article
- Isavuconazole and Liposomal Amphotericin B as Successful Combination Therapy of Refractory Invasive Candidiasis in a Liver Transplant Recipient: A Case Report and Literature Review.Mycopathologia · 2022Review
- Characteristics of antifungal utilization for hospitalized children in the United States.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Role of Antifungal Combinations in Difficult to TreatJournal of fungi (Basel, Switzerland) · 2021Review
- In Vitro Characterization of Twenty-One Antifungal Combinations against Echinocandin-Resistant and -SusceptibleJournal of fungi (Basel, Switzerland) · 2021Article
- Kinetic Control of Quorum Sensing in Pseudomonas aeruginosa by Multidrug Efflux Pumps.ACS infectious diseases · 2018Article
- Chemogenomic Profiling of the Fungal Pathogen Candida albicans.Antimicrobial agents and chemotherapy · 2018Article
- Changed gene expression in subjects with schizophrenia and low cortical muscarinic M1 receptors predicts disrupted upstream pathways interacting with that receptor.Molecular psychiatry · 2018Article
- Review
- Combination Antifungal Therapy: A Review of Current Data.Journal of clinical medicine research · 2017Review
- Potent Antifungal Synergy of Phthalazinone and Isoquinolones with Azoles AgainstACS medicinal chemistry letters · 2017Article
- Bioassay for Determining Voriconazole Serum Levels in Patients Receiving Combination Therapy with Echinocandins.Antimicrobial agents and chemotherapy · 2016Article
- Multilaboratory testing of antifungal drug combinations against Candida species and Aspergillus fumigatus: utility of 100 percent inhibition as the endpoint.Antimicrobial agents and chemotherapy · 2015Article
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Authors and funding
18 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There are few multilaboratory studies of antifungal combination testing to suggest a format for use in clinical laboratories. In the present study, eight laboratories tested quality control (QC) strain Candida parapsilosis ATCC 22019 and clinical isolates Candida albicans 20533.043, C. albicans 20464.007, Candida glabrata 20205.075, and C. parapsilosis 20580.070. The clinical isolates had relatively high azole and echinocandin MICs. A modified CLSI M27-A3 protocol was used, with 96-well custom-made plates containing checkerboard pairwise combinations of amphotericin B (AMB), anidulafungin (AND), caspofungin (CSP), micafungin (MCF), posaconazole (PSC), and voriconazole (VRC). The endpoints were scored visually and on a spectrophotometer or enzyme-linked immunosorbent assay (ELISA) reader for 50% growth reduction (50% inhibitory concentration [IC(50)]). Combination IC(50)s were used to calculate summation fractional inhibitory concentration indices (FICIs) (ΣFIC) based on the Lowe additivity formula. The results revealed that the IC(50)s of all drug combinations were lower or equal to the IC(50) of individual drugs in the combination. A majority of the ΣFIC values were indifferent (ΣFIC = 0.51 to 2.0), but no antagonism was observed (ΣFIC ≥ 4). Synergistic combinations (ΣFIC ≤ 0.5) were found for AMB-PSC against C. glabrata and for AMB-AND and AMB-CSP against C. parapsilosis by both visual and spectrophotometric readings. Additional synergistic interactions were revealed by either of the two endpoints for AMB-AND, AMB-CSP, AMB-MCF, AMB-PSC, AMB-VRC, AND-PSC, CSP-MCF, and CSP-PSC. The percent agreements among participating laboratories ranged from 37.5% (lowest) for AND-CSP and POS-VOR to 87.5% (highest) for AMB-MCF and AND-CSP. Median ΣFIC values showed a wide dispersion, and interlaboratory agreements were less than 85% in most instances. Additional studies are needed to improve the interlaboratory reproducibility of antifungal combination testing.
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Registered trials
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