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      In vitro susceptibility of Paracoccidioides brasiliensis yeast form to antifungal agents Translated title: Susceptibilidad in vitro de la forma levaduriforme de Paracoccidioides brasiliensis a los agentes antifungicos


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          A study was conducted to determine the susceptibility of P. brasiliensis yeast form to amphotericin B (A), ketoconazole (K), 5-fluorocytosine (5-FC) and rifampin (R). The three isolates tested produced minimal inhibitory concentrations (MICs) (mcg/ml) in the following range: A: 0.09-0.18; K: 0.001-0.007; 5-FC: 62.5-250 and R: 40-80. The minimal fungicidal concentrations (MFC) were several times higher than the corresponding MICs. Precise MFC for 5-FC were not obtained (> 500 mcg/ml). Combination of K plus A proved synergic, with the fractional inhibitory concentration (FIC) indices revealing synergy when the drugs were combined at the 1 to 1 and 1 to 5 MIC ratios. R (40 mcg/ml) appeared to antagonize K. These results indicate promise for the combined use of K plus A as a therapeutical regimen.

          Translated abstract

          Se realizó un estudio con el objeto de determinar la susceptibilidad de la fase levaduri-forme del P. brasiliensis a la Anfotericina B (A), el Ketoconazol (K), la 5-fluorocitosina (5-FC) y la rifampicina. Las 3 cepas estudiadas tuvieron las siguientes concentraciones inhibitorias mínimas (MIC) (mcg/ml) A: 0.09-0.18; K: 0.001-0.007; 5-FC: 62.5-250 y R: 40-80. Las concentraciones fungicidas mínimas (MFC) resultaron más altas que las MICs correspondientes. En el caso de la 5-FC no se obtuvo una cifra MFC precisa (> 500 mcg/ml). La combinación de K más A mostró ser sinérgica al combinarse las drogas en relación 1:1 y 1:5 de los MICs respectivos. R (40 mcg/ml) se mostró antagonista del K. Los resultados indican que la combinación A + K pudiera constituir un adecuado régimen terapéutico en ciertos pacientes.

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          A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptoccal meningitis.

          We compared amphotericin B therapy for cryptococcal meningitis with a newer regimen containing both amphotericin B and flucytosine. In 50 patients with 51 courses of therapy adherent to the protocol, 27 courses were with amphotericin B and 24 with the combination. Even though the combination regimen was given for only six weeks and amphotericin B for 10 weeks, the combination cured or improved more patients (16 vs 11), produced fewer failures or relapses (three vs. 11), more rapid sterilization of the cerebrospinal fluid (P less than 0.001) and less nephrotoxicity (P less than 0.05) than did amphotericin B alone. The number of deaths was the same (five) with each regimen. Adverse reactions to flucytosine occurred in 11 of 34 patients but were not life threatening. We conclude that combined flucytosine-amphoericin B therapy is the regimen of choice in cryptococcal meningitis.
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            Laboratory and clinical assessment of ketoconazole in deep-seated mycoses

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              Manual of clinical microbiology


                Author and article information

                Revista do Instituto de Medicina Tropical de São Paulo
                Rev. Inst. Med. trop. S. Paulo
                Instituto de Medicina Tropical (São Paulo, SP, Brazil )
                December 1984
                : 26
                : 6
                : 322-328
                [01] Medellín orgnameHospital Pablo Tobón Uribe Colombia
                S0036-46651984000600006 S0036-4665(84)02600600006

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                : 13 February 1984
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 7

                SciELO Brazil

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