In vitro comparison of terbinafine and itraconazole against Penicillium marneffei

We evaluated terbinafine and itraconazole against 30 isolates of Penicilliu m marneffei using a modification of the National Committee for Clinical Lab oratory Standards broth macrodilution MIC testing protocol for yeasts. The minimal fungicidal concentration (MFC) was determined by plating 100 mu l f rom each MIC drug dilution having no growth onto Sabouraud glucose agar inc ubated at 30 degrees C. The MFC was the dilution at which growth was absent at 72 h of incubation. The MICs, in micrograms per milliliter, were as fol lows: terbinafine, 0.03 to 1.0 (geometric mean titer, 0.09); itraconazole, 0.03 to 0.5 (geometric mean titer, 0.04). The MFCs, in micrograms per milli liter, were as follows: terbinafine, 0.03 to 8 (geometric mean titer, 2.60) ; itraconazole, 0.03 to 8 (geometric mean titer, 2.45). Primary fungicidal activity (MFC within 2 dilutions of MIG) was observed with terbinafine in e ight isolates and with itraconazole in four isolates. The data indicate tha t terbinafine is active against P. marneffei in vitro and may have a previo usly unrealized role in the management of infections caused by this fungus.