Antifungal susceptibility testing of micafungin against Candida glabrata isolates

Objective: Antifungal susceptibility of micafungin against isolates of C. glabrata was performed to evaluate the hypothesis that micafungin may be a suitable alternative in treating those patients whose infections are from C. glabrata and have developed resistance to fluconazole. Study design: A total of 119 clinical isolates were obtained from the oral cavity of 22 patients with oropharyngeal candidiasis or oral colonization with C. glabrata. All strains evaluated were from patients who had either HIV infection or were receiving radiation therapy for head and neck cancer. Inocula were prepared using Clinical Laboratory and Standards Institute (CLSI) M27-A2 guidelines. The plates were incubated at 35°C and the minimum inhibitory concentrations (MICs) were determined at 24 and 48 hours. Results: Micafungin exhibited good in vitro activity against most isolates, including those showing marked resistance to fluconazole. Conclusion: Micafungin has excellent antifungal effects in vitro against C. glabrata isolates and appears to be a good treatment option even against those isolates resistant to fluconazole. A clinical trial should be performed to confirm these findings.