Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1991 Feb;35(2):288–292. doi: 10.1128/aac.35.2.288

Comparison of fluconazole and amphotericin B for treatment of disseminated candidiasis and endophthalmitis in rabbits.

S G Filler 1, M A Crislip 1, C L Mayer 1, J E Edwards Jr 1
PMCID: PMC244993  PMID: 2024963

Abstract

We compared the efficacy of intravenous fluconazole (80 mg/kg of body weight per day) with that of amphotericin B (1 mg/kg/day) for the long-term treatment of endophthalmitis in rabbits with disseminated candidiasis. After 17 days of therapy, fluconazole decreased the fungal colony counts of the choroid-retinas significantly more than did the saline control (P less than 0.05); however, after 24 days of fluconazole therapy, this treatment effect was lost and fluconazole was no more effective than saline. In contrast, treatment for 24 days with amphotericin B reduced the vitreous and choroid-retina fungal colony counts significantly more than either fluconazole or saline (P less than 0.05 for both treatment groups). After 17 days of therapy, indirect ophthalmoscopy revealed less severe eye involvement in both antifungal treatment groups than in saline controls; however, this difference reached statistical significance only for the amphotericin B-treated rabbits (P less than 0.05). Also, there was a trend towards worsening eye lesions, as seen by indirect ophthalmoscopy, in the fluconazole-treated rabbits after 24 days of therapy, which roughly paralleled the quantitative culture results. Despite the presence of negative choroid-retina cultures, some rabbits in all treatment groups had persistently visible eye lesions, indicating that ophthalmoscopic resolution of Candida endophthalmitis may lag behind lesion sterilization. Amphotericin B was superior to fluconazole in the treatment of Candida endophthalmitis in this model.

Full text

PDF
288

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brooks R. G. Prospective study of Candida endophthalmitis in hospitalized patients with candidemia. Arch Intern Med. 1989 Oct;149(10):2226–2228. [PubMed] [Google Scholar]
  2. Crislip M. A., Edwards J. E., Jr Candidiasis. Infect Dis Clin North Am. 1989 Mar;3(1):103–133. [PubMed] [Google Scholar]
  3. Henderson D. K., Edwards J. E., Jr, Montgomerie J. Z. Hematogenous candida endophthalmitis in patients receiving parenteral hyperalimentation fluids. J Infect Dis. 1981 May;143(5):655–661. doi: 10.1093/infdis/143.5.655. [DOI] [PubMed] [Google Scholar]
  4. Jones D. B. Chemotherapy of experimental endogenous Candida albicans endophthalmitis. Trans Am Ophthalmol Soc. 1980;78:846–895. [PMC free article] [PubMed] [Google Scholar]
  5. Parke D. W., 2nd, Jones D. B., Gentry L. O. Endogenous endophthalmitis among patients with candidemia. Ophthalmology. 1982 Jul;89(7):789–796. doi: 10.1016/s0161-6420(82)34722-3. [DOI] [PubMed] [Google Scholar]
  6. Perfect J. R., Savani D. V., Durack D. T. Comparison of itraconazole and fluconazole in treatment of cryptococcal meningitis and candida pyelonephritis in rabbits. Antimicrob Agents Chemother. 1986 Apr;29(4):579–583. doi: 10.1128/aac.29.4.579. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Richardson K., Brammer K. W., Marriott M. S., Troke P. F. Activity of UK-49,858, a bis-triazole derivative, against experimental infections with Candida albicans and Trichophyton mentagrophytes. Antimicrob Agents Chemother. 1985 May;27(5):832–835. doi: 10.1128/aac.27.5.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Rogers T. E., Galgiani J. N. Activity of fluconazole (UK 49,858) and ketoconazole against Candida albicans in vitro and in vivo. Antimicrob Agents Chemother. 1986 Sep;30(3):418–422. doi: 10.1128/aac.30.3.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Rotrosen D., Edwards J. E., Jr, Gibson T. R., Moore J. C., Cohen A. H., Green I. Adherence of Candida to cultured vascular endothelial cells: mechanisms of attachment and endothelial cell penetration. J Infect Dis. 1985 Dec;152(6):1264–1274. doi: 10.1093/infdis/152.6.1264. [DOI] [PubMed] [Google Scholar]
  10. Saag M. S., Dismukes W. E. Azole antifungal agents: emphasis on new triazoles. Antimicrob Agents Chemother. 1988 Jan;32(1):1–8. doi: 10.1128/aac.32.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Savani D. V., Perfect J. R., Cobo L. M., Durack D. T. Penetration of new azole compounds into the eye and efficacy in experimental Candida endophthalmitis. Antimicrob Agents Chemother. 1987 Jan;31(1):6–10. doi: 10.1128/aac.31.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Troke P. F., Andrews R. J., Brammer K. W., Marriott M. S., Richardson K. Efficacy of UK-49,858 (fluconazole) against Candida albicans experimental infections in mice. Antimicrob Agents Chemother. 1985 Dec;28(6):815–818. doi: 10.1128/aac.28.6.815. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Van t Wout J. W., Mattie H., van Furth R. Comparison of the efficacies of amphotericin B, fluconazole, and itraconazole against a systemic Candida albicans infection in normal and neutropenic mice. Antimicrob Agents Chemother. 1989 Feb;33(2):147–151. doi: 10.1128/aac.33.2.147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Walsh T. J., Bacher J., Pizzo P. A. Chronic silastic central venous catheterization for induction, maintenance and support of persistent granulocytopenia in rabbits. Lab Anim Sci. 1988 Aug;38(4):467–471. [PubMed] [Google Scholar]
  15. Walsh T. J., Pizzo A. Treatment of systemic fungal infections: recent progress and current problems. Eur J Clin Microbiol Infect Dis. 1988 Aug;7(4):460–475. doi: 10.1007/BF01962595. [DOI] [PubMed] [Google Scholar]
  16. Warnock D. W., Burke J., Cope N. J., Johnson E. M., von Fraunhofer N. A., Williams E. W. Fluconazole resistance in Candida glabrata. Lancet. 1988 Dec 3;2(8623):1310–1310. doi: 10.1016/s0140-6736(88)92919-4. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES