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©2013 UpToDate ® Print Email In vitro susceptibility of Candida spp to systemically active antifungal agents determined by CLSI M27-A3 broth microdilution MIC methods Species Antifungal agents Number of isolates tested MIC, µg/ml Range 50 percent* 90 percent* Candida albicans Amphotericin B• 2728 0.016-4 0.5 0.5 Flucytosine 5208 0.12-128 0.25 1 Fluconazole 5827 0.12-128 0.25 0.5 Itraconazole 3895 0.03-8 0.06 0.12 Posaconazole 5827 0.007-2 0.015 0.06 Voriconazole 5826 0.007-4 0.007 0.015 Anidulafungin 2869 0.007-2 0.03 0.06 Caspofungin 2869 0.007-0.5 0.03 0.06 Micafungin 2869 0.007-1 0.015 0.03 C. glabrata Amphotericin B• 949 0.03-16 2 4 Flucytosine 1267 0.12-128 0.12 0.12 Fluconazole 1517 0.25-128 8 32 Itraconazole 1054 0.03-8 1 2 Posaconazole 1517 0.03->8 1 2 Voriconazole 1516 0.007-8 0.25 1 Anidulafungin 747 0.015-4 0.06 0.12 Caspofungin 747 0.015->8 0.03 0.06 Micafungin 747 0.007-1 0.015 0.015 C. parapsilosis Amphotericin B• 666 0.25-16 1 2 Flucytosine 1047 0.12-128 0.12 0.25 Fluconazole 1542 0.12-128 0.5 2 Itraconazole 1028 0.03-2 0.25 0.5 Posaconazole 1542 0.007-1 0.06 0.12 Voriconazole 1541 0.007-8 0.015 0.06 Anidulafungin 759 0.03-4 2 2 Caspofungin 759 0.015-4 0.25 1 Micafungin 759 0.015-2 1 1 C. tropicalis Amphotericin B• 528 0.06-32 1 2 Flucytosine 759 0.12-128 0.25 1 Fluconazole 1198 0.12-128 0.5 2 Itraconazole 839 0.03-8 0.12 0.25 Posaconazole 1198 0.015-2 0.06 0.12 Voriconazole 1197 0.007-8 0.03 0.06 Anidulafungin 625 0.007-2 0.03 0.06 Caspofungin 625 0.007->8 0.03 0.06 Micafungin 625 0.007-1 0.03 0.06 C. krusei Amphotericin B• 143 0.03-16 4 8 Flucytosine 184 0.12-128 16 32 Fluconazole 305 8-128 32 64 Itraconazole 206 0.06-4 0.5 1 Posaconazole 305 0.03-4 0.25 1 Voriconazole 305 0.06-4 0.25 0.5 Anidulafungin 136 0.015-0.5 0.06 0.06 Caspofungin 136 0.015-1 0.12 0.25 Micafungin 136 0.015-0.25 0.06 0.12 C. guilliermondii Amphotericin B• 102 0.06-32 0.25 1 Flucytosine 100 0.12-4 0.12 0.5 Fluconazole 138 0.5-32 4 8 Itraconazole 90 0.06-4 0.5 1 Posaconazole 138 0.015-2 0.25 0.5 Voriconazole 138 0.015-2 0.06 0.12 Anidulafungin 61 0.12-4 1 2 Caspofungin 61 0.03->8 0.5 1 Micafungin 61 0.015-2 0.5 1 C. lusitaniae Amphotericin B• 103 0.06-16 0.25 1 Flucytosine 82 0.12-128 0.12 0.5 Fluconazole 133 0.12-64 0.5 1 Itraconazole 89 0.03-1 0.12 0.25 Posaconazole 133 0.015-1 0.03 0.12 Voriconazole 133 0.007-1 0.007 0.015 Anidulafungin 58 0.06-1 0.5 0.5 Caspofungin 58 0.03-1 0.25 0.5 Micafungin 58 0.03-1 0.12 0.25 CLSI: Clinical and Laboratory Standards Institute; MIC: minimum inhibitory concentration. * MIC encompassing 50 percent and 90 percent of isolates tested, respectively. • Amphotericin B MICs determined by Etest. Data from:

Voriconazole 133 0.007-1 0.007 0.015 Anidulafungin 58 0.06-1 0.5 0.5 Caspofungin 58 0.03-1 0.25 0.5 Micafungin 58 0.03-1 0.12 0.25 CLSI: Clinical and Laboratory Standards Institute; MIC: minimum inhibitory concentration. * MIC encompassing 50 percent and 90 percent of isolates tested, respectively. • Amphotericin B MICs determined by Etest. Data from: Pfaller, MA, Boyken, L, Hollis, RJ, et al. In vitro susceptibility of invasive isolates of Candida spp. to anidulafungin, caspofungin, and micafungin: six years of global surveillance. J Clin Microbiol 2008; 46:150. Pfaller, MA, Messer, SA, Boyken, L, et al. In vitro activities of 5-fluorocytosine against 8803 clinical isolates of Candida spp.: global assessment of primary resistance using National Committee for Clinical Laboratory Standards susceptibility testing methods. Antimicrob Agents Chemother 2002; 46:3518. Pfaller, MA, Messer, SA, Boyken, L, et al. Cross-resistance between fluconazole and ravuconazole and the use of fluconazole as a surrogate marker to predict susceptibility and resistance to ravuconazole among 12,796 clinical isolates of Candida spp. J Clin Microbiol 2004; 42:3137. Pfaller, MA, Boyken, L, Hollis, RJ, et al. In vitro susceptibilities of clinical isolates of Candida species, Cryptococcus neoformans, and Aspergillus species to itraconazole: global survey of 9359 isolates tested by Clinical and Laboratory Standards Institute broth microdilution methods. J Clin Microbiol 2005; 43: 3807. Pfaller, MA, Messer, SA, Boyken, L, et al. Selection of a surrogate agent (fluconazole or voriconazole) for initial susceptibility testing of posaconazole against Candida spp.: results from a global antifungal surveillance program. J Clin Microbiol 2008; 46:551.