amphotericin-b and albaconazole

Eighty-four isolates belonging to eight species that constitute the Pseudallescheria boydii complex were tested against 11 antifungal agents by using the microdilution method. There were significant differences among the species, with Scedosporium aurantiacum being the most resistant. In general, voriconazole was the most active drug, followed by posaconazole.

Topics: Amphotericin B; Antifungal Agents; Candida; Drug Resistance, Fungal; Echinocandins; Fluconazole; Flucytosine; Humans; Itraconazole; Ketoconazole; Lipopeptides; Lipoproteins; Micafungin; Microbial Sensitivity Tests; Naphthalenes; Peptides, Cyclic; Pseudallescheria; Pyrimidines; Quality Control; Quinazolines; Scedosporium; Terbinafine; Thiazoles; Triazoles; Voriconazole

We have studied the in vitro interactions of amphotericin B (AMB) with terbinafine (TBF), itraconazole, voriconazole (VCZ), albaconazole, and ravuconazole (RVZ), as well as TBF combined with the same azoles, against 11 isolates of Fusarium spp. using the fractional inhibitory concentration index. The highest percentage of synergistic interactions was observed for the combinations AMB-RVZ, TBF-VCZ, and TBF-RCZ.

Topics: Amphotericin B; Antifungal Agents; Drug Interactions; Drug Resistance, Fungal; Fusarium; Humans; Itraconazole; Microbial Sensitivity Tests; Naphthalenes; Pyrimidines; Quinazolines; Sensitivity and Specificity; Terbinafine; Thiazoles; Triazoles; Voriconazole

A series of azole antifungal agents featuring a quinazolinone nucleus have been subjected to studies of structure-activity relationships. In general, these compounds displayed higher in vitro activities against filamentous fungi and shorter half-lives than the structures described in our preceding paper. The most potent products in vitro carried a halogen (or an isostere) at the 7-position of the quinazolinone ring. Using a murine model of systemic candidosis, oral activity was found to be dependent on hydrophobicity, which, in turn, modulated the compound's half-life. The 7-Cl derivative, (1R,2R)-7-chloro-3-[2-(2, 4-difluorophenyl)-2-hydroxy-1-methyl-3-(1H-1,2, 4-triazol-1-yl)propyl]quinazolin-4(3H)-one (20, UR-9825), was selected for further testing due to its high in vitro activity, low toxicity, good pharmacokinetic profile, and ease of obtention. Compound 20 is the (1R,2R) isomer of four possible stereoisomers. The other three isomers were also prepared and tested. The enantiomer (1S,2S) and the (1R,2S) epimer were inactive, whereas the (1S,2R) epimer retained some activity. In vitro 20 was superior to fluconazole, itraconazole, SCH-42427, and TAK-187 and roughly similar to voriconazole and ER-30346. In vivo, 20 was only moderately active in a mouse model of systemic candidosis when administration was limited to the first day. This was attributed to its short half-life in that species (t1/2 = 1 h po). Protection levels comparable to or higher than those of fluconazole, however, were observed in systemic candidosis models in rat and rabbit, where the half-life of the compound was found to be 6 and 9 h, respectively. Finally, 20 showed excellent protection levels in an immunocompromised rat model of disseminated aspergillosis. The compound showed low toxicity signs when administered to rats at 250 mg/kg qd or at 100 mg/kg bid during 28 days.

Topics: Animals; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Candidiasis; Colony Count, Microbial; Fungi; Male; Mice; Molecular Conformation; Quinazolines; Rabbits; Rats; Rats, Sprague-Dawley; Stereoisomerism; Structure-Activity Relationship; Triazoles