Do in vitro susceptibility data predict the microbiologic response to amphotericin B? Results of a prospective study of patients with Candida fungemia

M. Hong Nguyen, Cornelius J. Clancy, Victor L. Yu, Yue C. Yu, Arthur J. Morris, David R. Snydman, Deanna A. Sutton, Michael G. Rinaldi

Research output: Contribution to journalArticlepeer-review

181 Scopus citations

Abstract

Outcome for 105 patients with candidemia treated with amphotericin B was correlated with amphotericin B in vitro susceptibility results. Thirty-three patients had microbiologic failure, which was defined as persistence of Candida in the bloodstream despite ≤3 days of amphotericin B. Amphotericin B minimum inhibitory concentrations (MICs) were determined by the National Committee for Clinical Laboratory Standards methodology. After determination of MICs, the minimal lethal concentrations (MLCs) were determined. The isolates tested yielded a narrow range of amphotericin B MICs (0.06-2 μg/mL); only 5% (5/105) exhibited MICs ≤1 μg/mL. The MLC range, on the other hand, was significantly broader (0.125 to > 16 μg/mL); 24% (25/105) exhibited MLCs ≤1 μg/mL. The strongest predictor for microbiologic failure was 48-h MLC (P < .001), followed by 24-h MLC (P = .03) and 48-h MIC (P = .11). A resistant break point for amphotericin B of >1 μg/mL for MLC and ≤ 1 μg/mL for MIC could be inferred from this study.

Original languageEnglish (US)
Pages (from-to)425-430
Number of pages6
JournalJournal of Infectious Diseases
Volume177
Issue number2
DOIs
StatePublished - 1998

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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