In vitro antifungal activity of Indian liposomal amphotericin B against clinical isolates of emerging species of yeast and moulds, and its comparison with amphotericin B deoxycholate, voriconazole, itraconazole and fluconazole

Abstract

Fungisome(TM) is a liposomal preparation of amphotericin B (AMB), already marketed in India. However, its antifungal activity has not been evaluated against a wide range of fungal pathogens. The study was planned to elucidate the in vitro antifungal activity of Fungisome(TM) against wide range of fungi and compare it with AMB deoxycholate (AMB-d), voriconazole (VOR), itraconazole (ITR) and fluconazole (FLU). Minimum inhibitory concentrations (MICs) of the drugs were determined for 262 clinical fungal isolates, including yeast, dimorphic and filamentous fungi, by broth microdilution method approved by Clinical and Laboratory Standards Institute, USA (yeast, M27-A3; filamentous fungi, M38-A2). The MIC(90s) of Fungisome(TM) were 0.125, 0.5 and 0.25 mg l(-1) against yeast, filamentous and dimorphic fungi respectively. In comparison, MIC(90s) of AMB-d, FLU, ITR and VOR were 1, 1 and 1 mg l(-1) (AMB-d), 4, 64 and 64 mg l(-1) (FLU), 1, 16 and 16 mg l(-1) (ITR) and 0.5, 4 and 16 mg l(-1) (VOR) against yeast, filamentous and dimorphic fungi respectively. The MIC of Fungisome(TM) was two to 16-fold lower than AMB-d. These results reveal an efficient in vitro activity of Fungisome(TM).