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J Med Microbiol 57 (2008), 457-462; DOI: 10.1099/jmm.0.47651-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Synergistic activity of azoles with amiodarone against clinically resistant Candida albicans tested by chequerboard and time–kill methods

Qiongjie Guo1, Shujuan Sun2, Jinlong Yu1,3, Yan Li2 and Lili Cao4

1 School of Pharmaceutical Sciences, Shandong University, Jinan 250012, PR China

2 Department of Pharmacy, Shandong Provincial Qianfoshan Hospital, Jinan 250014, PR China

3 Department of Pharmacy, The Second Hospital of Shandong University, Jinan 250012, PR China

4 The General Surgical Central Laboratory, Shandong Provincial Qianfoshan Hospital, Jinan 250014, PR China

Correspondence
Shujuan Sun
sunshujuan888{at}163.com

Received 25 September 2007
Accepted 4 December 2007

Candida albicans is the most common candidal pathogen, causing serious systemic disease in immunocompromised patients. Azoles are widely applied and largely effective; however, they are generally fungistatic and clinically resistant isolates are emerging increasingly. The present study provided in vitro evidence using a chequerboard technique that amiodarone is strongly synergistic with azoles against resistant C. albicans, with mean fractional inhibitory concentration indices of 0.01 and high-percentage synergistic interactions of 1250 %. A time–kill study performed by both colony counting and a colorimetric reduction assay confirmed the synergistic interaction, with a ≥2 log10 decrease in c.f.u. ml–1 compared with the corresponding azoles alone. These results suggest the possibility of supplementing azoles with amiodarone to treat resistant C. albicans infections.

Abbreviations: AMD, amiodarone; BI, Bliss independence; CI, confidence interval; FIC, fractional inhibitory concentration; FICI, FIC index; FLC, fluconazole; ITC, itraconazole; LA, Loewe additivity; VRC, voriconazole; XTT, 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide.




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