TABLE 4.
Summary of responses in vivo and in vitro in fluconazole
| Isolate, MICs | In vivo response rankinga
|
Modal MIC (μg/ml) at the following time and endpointb:
|
|||
|---|---|---|---|---|---|
| By survival | By nos. of CFU/g in kidney | 48 h, 80% | 24 h, 80% | 24 h, 50% | |
| C. albicans, low/low | Fair | Good | 0.25 | 0.125 | 0.06 |
| C. tropicalis, low/low | Good | Fair | 0.125 | 0.125 | 0.06 |
| C. albicans, low/high | Good | Good | ≥64 | 0.25 | 0.25 |
| C. tropicalis, low/high | Fair | Fair | ≥64 | 0.5 | 0.5 |
| C. tropicalis, high/high | Good | Fair | ≥64 | ≥64 | 0.5 |
| C. albicans, high/high | Poor | Poor | 16 | 16 | 8 |
On the basis of the response to 1 mg of fluconazole per kg/day, the isolates were sorted by best to worst response and were then grouped by inspection into descriptive categories of good, fair, or poor response to therapy. For example, good response in the survival ranking corresponds to a ≥5-day increase in survival, fair corresponds to a 3- to 4-day increase, and poor corresponds to a <1-day increase.
Modal MICs read at 48 and 24 h and determined by the four variations of the M27-A method that use an 80% growth reduction endpoint (data in Table 1) along with the MIC that would be obtained after 24 h if only a 50% reduction in growth compared with the growth control were required (data in Fig. 1).