IN-VITRO ACTIVITIES OF VORICONAZOLE (UK-109,496) AND 4 OTHER ANTIFUNGAL AGENTS AGAINST 394 CLINICAL ISOLATES OF CANDIDA SPP

Voriconazole (formerly UK-109,496) is a new monotriazole antifungal ag ent which has potent activity against Candida, Cryptococcus, and Asper gillus species. We investigated the in vitro activity of voriconazole compared to those of fluconazole, itraconazole, amphotericin B, and fl ucytosine (5FC) against 394 bloodstream isolates of Candida (five spec ies) obtained from more than 30 different medical centers. MICs df all antifungal drugs were determined by the method recommended by the Nat ional Committee for Clinical Laboratory Standards using RPMI 1640 test medium. Overall, voriconazole was quite active against all the yeast isolates (MIC at which 90% of the isolates are inhibited [MIC90], less than or equal to 0.5 mu g/ml). Candida albicans was the most suscepti ble species (MIC90, 0.06 mu g/ml) and Candida glabrata and Candida kru sei were the least (MIC90, 1 mu g/ml). Voriconazole was more active th an amphotericin B and 5FC against all species except C. glabrata and w as also more active than itraconazole and fluconazole. For isolates of Candida spp, with decreased susceptibility to fluconazole and itracon azole MICs of voriconazole were also higher. Based on these results, v oriconazole has promising antifungal activity and further in vitro and in vivo investigations are warranted.