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Activity of Amphotericin B, Anidulafungin, Caspofungin, Micafungin, Posaconazole, and Voriconazole Against Candida Albicans With Decreased Susceptibility to Fluconazole From Apeced Patients on Long-Term Azole Treatment of Chronic Mucocutaneous Candidiasis

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED, APS-I) is exceptionally common in Finland. Most patients have chronic oral candidiasis since childhood. Thus, most patients receive repeated courses of antifungals throughout their life. Eleven of our patients (31.4%) have become colonized with Candida albicans with decreased sensitivity to fluconazole. A total of 43 isolates of C. albicans from 23 APECED patients isolated during the years 1994 to 2004 were divided into 2 groups: fluconazole-susceptible dose-dependent (MIC, 16-32 μg/mL, 18 isolates) and fluconazole-susceptible (MIC ≤8 μg/mL, 25 isolates) groups. Antifungal activity of amphotericin B, echinocandins, and azoles was determined by the Clinical and Laboratory Standards Institute M27-A2 methodology. All isolates were highly susceptible to amphotericin B and echinocandins. Posaconazole and voriconazole were active against all isolates. Our data suggest that topical amphotericin B could continue to be a safe and active drug for daily administration for APECED patients. Posaconazole, voriconazole, and echinocandins may be useful in some complicated cases.

Identiferoai:union.ndltd.org:ETSU/oai:dc.etsu.edu:etsu-works-18820
Date01 October 2008
CreatorsRautemaa, Riina, Richardson, Malcolm, Pfaller, Michael A., Perheentupa, Jaakko, Saxén, Harri
PublisherDigital Commons @ East Tennessee State University
Source SetsEast Tennessee State University
Detected LanguageEnglish
Typetext
SourceETSU Faculty Works

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