colistin and Mycoses

The literature on the clinical use of rifampicin in combination for the treatment of non-mycobacterial diseases is reviewed. From the published evidence, the most promising associations are, for staphylococcal infections, gentamicin, erythromycin, kanamycin and fusidic acid. In the field of Gram-negative infections, Psuedomonas-induced sepsis in particular, data are not so impressive but promising results have been obtained with the associated use of rifampicin and gentamicin or colistin. Some systemic fungal diseases may be successfully treated with rifampicin in combination with amphotericin-B. Although only few reports are available on this subject, the importance of such an application is stressed in view of the severity of these diseases and of the lack of appropriate treatments.

Topics: Amphotericin B; Cephalosporins; Chloramphenicol; Colistin; Drug Therapy, Combination; Endocarditis, Bacterial; Erythromycin; Gentamicins; Humans; Kanamycin; Lincomycin; Mycoses; Nalidixic Acid; Penicillins; Pseudomonas Infections; Respiratory Tract Infections; Rifampin; Staphylococcal Infections; Sulfamethoxazole; Tetracyclines; Trimethoprim; Urinary Tract Infections; Vancomycin

Nonabsorbable antibiotics for selective bowel decontamination (SBD) sometimes are administered to liver transplant patients to prevent postoperative infections, but the efficacy of SBD is not known. Accordingly, we prospectively studied 69 patients randomly assigned to receive conventional prophylaxis with systemic antibiotics (control patients) or conventional prophylaxis plus oral nonabsorbable antibiotics for SBD (SBD patients). Overall rates of bacterial and/or yeast infections were nearly equal among control patients (42%) and SBD patients (39%). However, the infection rate at SBD key sites (abdomen, bloodstream, surgical wound, and lungs) was lower among patients who received the SBD regimen > or = 3 days before transplantation (23%) than among control patients (36%). Administration of the SBD regimen was complicated by gastrointestinal intolerance and noncompliance but not by increased stool colonization with antibiotic-resistant gram-negative bacilli. Practical problems associated with administering an SBD regimen to patients awaiting cadaver liver transplants limit the regimen's usefulness, but we found a trend toward reduced key site infection when the regimen was given > or = 3 days before transplantation.

Topics: Ampicillin; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Cefotaxime; Colistin; Drug Administration Schedule; Evaluation Studies as Topic; Feces; Female; Gentamicins; Humans; Intestines; Liver Transplantation; Male; Mycoses; Nystatin; Risk Factors; Treatment Outcome

Topics: Adult; Amphotericin B; Antifungal Agents; Aspergillus fumigatus; Colistin; Digestive System; Drug Therapy, Combination; Fluconazole; Humans; Liver Transplantation; Middle Aged; Mycoses; Retrospective Studies; Risk Factors; Sputum; Tobramycin

Topics: Acute Disease; Anti-Bacterial Agents; Bone Marrow Transplantation; Clinical Trials as Topic; Colistin; Drug Combinations; Humans; Infection Control; Leukemia, Myeloid; Mycoses; Neomycin; Prospective Studies; Random Allocation; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Animals; Anti-Infective Agents; Bacterial Infections; Cats; Colistin; Dogs; Drug Resistance, Microbial; Humans; Infections; Mycoses; Parasitic Diseases; Virus Diseases; Zoonoses

Various fungi have the ability to colonize surfaces and to form biofilms. Fungal biofilm-associated infections are frequently refractory to targeted treatment because of resistance to antifungal drugs. One fungus that frequently colonises the respiratory tract of cystic fibrosis (CF) patients is the opportunistic black yeast-like fungus Exophiala dermatitidis. We investigated the biofilm-forming ability of E. dermatitidis and its susceptibility to various antiinfective agents and natural compounds. We tested 58 E. dermatitidis isolates with a biofilm assay based on crystal violet staining. In addition, we used three isolates to examine the antibiofilm activity of voriconazole, micafungin, colistin, farnesol, and the plant derivatives 1,2,3,4,6-penta-O-galloyl-b-D-glucopyranose (PGG) and epigallocatechin-3-gallate (EGCG) with an XTT reduction assay. We analysed the effect of the agents on cell to surface adhesion, biofilm formation, and the mature biofilm. The biofilms were also investigated by confocal laser scan microscopy. We found that E. dermatitidis builds biofilm in a strain-specific manner. Invasive E. dermatitidis isolates form most biomass in biofilm. The antiinfective agents and the natural compounds exhibited poor antibiofilm activity. The greatest impact of the compounds was detected when they were added prior cell adhesion. These findings suggest that prevention may be more effective than treatment of biofilm-associated E. dermatitidis infections.

Topics: Antifungal Agents; Bacterial Adhesion; beta-Glucans; Biofilms; Catechin; Colistin; Cystic Fibrosis; Echinocandins; Exophiala; Farnesol; Humans; Lipopeptides; Micafungin; Microbial Sensitivity Tests; Mycoses; Voriconazole

Chytridiomycosis caused by the chytrid fungus Batrachochytrium salamandrivorans (Bsal) poses a serious threat to urodelan diversity worldwide. Antimycotic treatment of this disease using protocols developed for the related fungus Batrachochytrium dendrobatidis (Bd), results in therapeutic failure. Here, we reveal that this therapeutic failure is partly due to different minimum inhibitory concentrations (MICs) of antimycotics against Bsal and Bd. In vitro growth inhibition of Bsal occurs after exposure to voriconazole, polymyxin E, itraconazole and terbinafine but not to florfenicol. Synergistic effects between polymyxin E and voriconazole or itraconazole significantly decreased the combined MICs necessary to inhibit Bsal growth. Topical treatment of infected fire salamanders (Salamandra salamandra), with voriconazole or itraconazole alone (12.5 μg/ml and 0.6 μg/ml respectively) or in combination with polymyxin E (2000 IU/ml) at an ambient temperature of 15 °C during 10 days decreased fungal loads but did not clear Bsal infections. However, topical treatment of Bsal infected animals with a combination of polymyxin E (2000 IU/ml) and voriconazole (12.5 μg/ml) at an ambient temperature of 20 °C resulted in clearance of Bsal infections. This treatment protocol was validated in 12 fire salamanders infected with Bsal during a field outbreak and resulted in clearance of infection in all animals.

Topics: Animals; Antifungal Agents; Chytridiomycota; Colistin; Drug Synergism; Drug Therapy, Combination; Microbial Sensitivity Tests; Mycoses; Temperature; Urodela; Voriconazole

Because published reports indicate that the antibiotic colistin (COL) has antifungal properties, this study investigated the antifungal in vitro activity of COL as single agent and in combination with the antifungal compounds voriconazole (VRC), caspofungin (CAS) and amphotericin B (AMB) against Scedosporium/Pseudallescheria spp., Exophiala dermatitidis and Geosmithia argillacea. In total, susceptibility was determined for 77 Scedosporium/Pseudallescheria spp., 82 E. dermatitidis and 17 G. argillacea isolates. The minimal inhibitory concentrations (MICs) of COL and the antifungals as single compound and in combination were determined with MIC test strips. Drug interactions were detected by crossing the MIC test strips at a 90º angle. The fractional inhibitory concentration index was used to categorise the drugs' interaction. The MIC50 value of COL was 12 μg ml(-1) for S. prolificans, 16 μg ml(-1) for P. apiosperma, 16 μg ml(-1) for P. boydii, 12 μg ml(-1) for E. dermatiditis and 6 μg ml(-1) for G. argillacea. VRC was the most active drug in combination without any antagonism with the exception of few P. boydii isolates. COL as single agent and in most combinations with antifungals exhibits in vitro antifungal activity against filamentous ascomycetes occurring in cystic fibrosis patients and may offer a novel therapeutic option, especially for multidrug-resistant S. prolificans.

Topics: Amphotericin B; Antifungal Agents; Caspofungin; Colistin; Cystic Fibrosis; Drug Evaluation, Preclinical; Drug Synergism; Echinocandins; Exophiala; Humans; Lipopeptides; Microbial Sensitivity Tests; Mitosporic Fungi; Mycoses; Pyrimidines; Scedosporium; Triazoles; Voriconazole

Topics: Animals; Bacteria, Aerobic; Bacterial Infections; Colistin; Drug Therapy, Combination; Enterobacteriaceae; Female; Intestine, Small; Liver; Liver Transplantation; Lung; Lymph Nodes; Mycoses; Nystatin; Postoperative Complications; Spleen; Swine; Tobramycin; Transplantation, Autologous; Vancomycin

Topics: Aged; Amphotericin B; Bronchial Diseases; Colistin; Flucytosine; Geotrichosis; Humans; Lung Diseases, Fungal; Male; Microbial Sensitivity Tests; Middle Aged; Mitosporic Fungi; Mycoses; Neomycin; Potassium Iodide; Sulfadiazine

Topics: Adult; Amphotericin B; Colistin; Diagnosis, Differential; Endocarditis, Subacute Bacterial; Humans; Hydrocortisone; Infusions, Parenteral; Injections, Intravenous; Male; Mycoses; Penicillins; Shock, Septic; Streptomycin

Topics: Adrenal Cortex Hormones; Antifungal Agents; Colistin; Corneal Ulcer; Diagnosis, Differential; Herpes Zoster Ophthalmicus; Humans; Idoxuridine; Keratitis; Keratoconus; Mycoses; Natamycin; Nystatin; Polymyxins

Topics: Asthma; Bronchitis; Colistin; Female; Humans; In Vitro Techniques; Lung Diseases, Fungal; Middle Aged; Mycoses; Prednisolone