In vitro activities of voriconazole, fluconazole, and itraconazole against566 clinical isolates of Cryptococcus neoformans from the United States and Africa

We investigated the in vitro activity of voriconazole compared to those of fluconazole and itraconazole against 566 clinical isolates of Cryptococcus neoformans from Africa (164) and the United States (402). Isolates were obt ained from cerebrospinal fluid (362), blood (139), and miscellaneous sites (65). Voriconazole (MIC at which 90% of the isolates are inhibited [MIC90], 0.12 to 0.25 mu g/ml) was more active than either itraconazole (MIC90, 0.5 mu g/ml) or fluconazole (MIC90, 8.0 to 16 mu g/ml) against both African an d U.S. isolates. Isolates inhibited by greater than or equal to 16 mu g of fluconazole per ml were almost all (99%) inhibited by less than or equal to 1 mu g of voriconazole per ml These results suggest that voriconazole may be useful in the treatment of cryptococcosis.