伊曲康唑联合卡泊芬净或特比萘芬对球形孢子丝菌体外抑菌作用的研究

In vitro interactions of itraconazole with caspofungin or terbinafine against Sporothrix globosa

目的探讨伊曲康唑联合卡泊芬净或特比萘芬时对球形孢子丝菌酵母相和菌丝相的体外抑菌作用。方法参照标准的微量液基稀释法及棋盘微量稀释法对33株球形孢子丝菌行药敏试验,结果使用抑菌浓度指数(FICI)判定"协同""不相关"和"拮抗"。结果伊曲康唑与卡泊芬净联合对球形孢子丝菌酵母相菌株的协同率为93.94%(31/33),与特比萘芬联合的协同率为60.61%(20/33);伊曲康唑与卡泊芬净或特比萘芬联合对菌丝相菌株协同率分别为96.97%(32/33)、84.5%(28/33)。对所有受试菌株均未观察到上述药物的拮抗作用。结论体外联合药敏试验结果显示伊曲康唑与卡泊芬净或特比萘芬联合有较好的协同作用。

Sporotrichosis is a common fungal infection with limited therapeutic strategies. Combination of synergistic drugs could provide new angle for treating this disease. We used the standard broth microdilution and checkerboard method to evaluate the in vitro efficacy of combining itraconazole with caspofungin or terbinafine against the yeast and mycelial phases of Sporothrix globosa. Fractional inhibitory concentration index （FICI） was used to interprete the result as following： synergistic if the FICI is ≤0.5; in- different if the FICI is 〉0.5 but ≤4 and antagonistic if the FICI is 〉4. For yeast phase, the synergic interaction of itraconazole combined with caspofungin or terbinafine was 93.94% （31/33） and 60.61% （20/33） , respectively; for mycelial phase, the syn- ergic interaction of itraconazole combined with caspofungin or terbinafine was 96.97 % （ 32/33 ） and 84.5 % （20/33） , respectively. Antagonism was not observed. The in vitro efficacy of combining itraconazole with caspofungin or terbinafine showed perfect synergy against S. globosa , suggesting a potential therapeutic choice for treatment of Sporotrichosis.