Abstract
Due to the increase of choices relative to antifungals, there is a need to improve the standardization of in vitro methods used to determine the antifungal susceptibility of fungal pathogens. Our study evaluated the in vitro susceptibility of filamentous fungi isolated from patients with toenail onychomycosis against itraconazole, ciclopirox, eberconazole, fluconazole and terbinafine. The minimum inhibitory concentration (MIC) of these antifungal agents was determined with 100 isolates, including dermatophytes (70 strains) and non-dermatophyte molds (30 strains). The susceptibility of fungal isolates was measured by using a technique modified for dermatophytes (0.5 × 103–0.5 × 104 conidia/ml as inocula) which followed the procedures described by the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST) and the Clinical and Laboratory Standard Institute (CLSI M38-A). MIC ranges were 0.016–8.0 μg/ml for itraconazole, ciclopirox and eberconazole, 0.063–32.0 μg/ml for fluonazole, and 0.004–2.0 μg/ml for terbinafine. In vitro susceptibility tests indicated that eberconazole has a broad antimicrobial profile, including dermatophytes, as well as other filamentous fungi. Terbinafine was active (0.016–0.250 μg/ml) against dermatophytes.
Acknowledgments
This study was partially financed by the program of ‘Escola Universitaria d'infermeria’ to AZ. The assistance of Robin Rycroft (SAL.UB) in the preparation of the English version of the manuscript is gratefully acknowledged.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper was first published online on Early Online on 15 December 2010.