TABLE 5.
In vitro studies of drug combinations against Scedosporium spp.
| Species | No. of strains | Drug combination (drug A + drug B) | Median MIC (range), μg/ml
|
Interactionb (% of strains) | Reference | |||
|---|---|---|---|---|---|---|---|---|
| Drugs alone
|
Drugs in combination
|
|||||||
| Drug A | Drug B | Drug A | Drug B | |||||
| S. prolificans | 20 | Terbinafine + itraconazole | 32 (4->64) | >32 (>32) | 1 (0.5-4) | 1 (0.5-16) | SYN (85), ADD (15) | 288 |
| 5 | Terbinafine + voriconazole | >64 (>64) | 8 (4-16) | 9.51 (2-32) | 0.71 (0.03-2) | SYN (100) | 287 | |
| 5 | Terbinafine + miconazole | >64 (>64) | 64 (8->64) | 2 (1-4) | 2 (0.13-8) | SYN (100) | 287 | |
| 30 | Amphotericin B + pentamidine | 32 (4-32) | 64 (8-128) | 2 (1-4) | 8 (2-32) | SYN (93), ADD (7) | 4 | |
| 4 | Voriconazole + micafungin | 4 (2-4) | 256 (256) | 1 (1-2) | 0.5 (13-64) | SYN (75), ADD (15) | 188 | |
| 17 | Amphotericin B + micafungin | >8 (1->8) | >32 (>32) | 4 (0.5-8) | 16 (0.06-16) | SYN (84), ADD (16) | 489 | |
| S. apiospermum | 3 | Voriconazole + micafungin | 0.13 (0.13-0.25) | 32 (0.25-128) | 0.06 (0.06) | 0.25 (0.13-0.5) | SYN (66), ADD (33) | 188 |
| 19 | Amphotericin B + micafungin | 8 (0.5->8) | 2 (1->32) | 1 (0.12-8) | 1 (0.12-8) | SYN (31), ADD (69) | 489 | |
| 8 | Amphotericin B + miconazole | 1 (0.25-2) | 0.25 (0.13-0.5) | NAa | NA | SYN (13), ADD (63) | 458 | |
| 8 | Amphotericin B + itraconazole | 1 (0.25-2) | 0.25 (0.03-0.5) | NA | NA | SYN (25), ADD (13) | 458 | |
| 8 | Amphotericin B + fluconazole | 1 (0.25-2) | 16 (4-32) | NA | NA | SYN (38), ADD (50) | 458 | |
a
NA, not available.
b
Synergy (SYN) was defined as being when fractional inhibitory indices were ≤0.5. Additivity (ADD) was defined as being when fractional inhibitory indices were >0.5 and ≤1. The remaining isolates showed indifferent interactions (fractional inhibitory indices of >1 and <4). No antagonism was observed (fractional inhibitory index, >4).