In vitro susceptibility of chromoblastomycosis agents to antifungal drugs - a systematic review

Publication date: Available online 25 September 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Alessandra Helena da Silva Hellwig, Daiane Heidrich, Régis Adriel Zanette, Maria Lúcia ScrofernekerAbstractChromoblastomycosis (CBM) is a chronic granulomatous mycosis caused by dematiaceous fungi, which affects cutaneous and subcutaneous tissues. The standard antifungal drug for treatment is itraconazole, followed by terbinafine. However, the cure rates vary from 15 to 80% when these drugs are used in monotherapy. A systematic review on the in vitro susceptibility of CBM agents to antifungal drugs, alone and in combination, was conducted using the Cochrane methodology. Forty-seven search terms were included in the PICOS method of searching electronic databases. The search resulted in 35 studies, from which eight evaluated antifungal drugs in combination. Based on the minimum inhibitory concentrations, posaconazole, terbinafine, itraconazole and voriconazole were, in descending order, the most effective antifungal drugs against CBM agents in vitro. In drug combination studies, only terbinafine-voriconazole and itraconazole-caspofungin showed 100% of synergism for Fonsecaea pedrosoi, Exophiala jeanselmei and Phialophora verrucosa. Nonetheless, none of the combinations studied showed antagonism.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research