In Vitro Activity of the New Triazole Voriconazole (UK-109,496) against Opportunistic Filamentous and Dimorphic Fungi and Common and Emerging Yeast Pathogens

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Abstract
The in vitro antifungal activity of a new triazole derivative, voriconazole, was compared with those of itraconazole and amphotericin B against 67 isolates ofAspergillus flavus,Aspergillus fumigatus,Bipolarisspp.,Fusarium oxysporum,Fusarium solani,Pseudallescheria boydii,Rhizopus arrhizus,Blastomyces dermatitidis,Histoplasma capsulatum, andSporothrix schenckii. The in vitro activities of voriconazole were also compared with those of amphotericin B, fluconazole, and itraconazole against 189 isolates of emerging and common yeast pathogens ofBlastoschizomyces capitatus,Candida(13 species),Cryptococcus neoformans,Hansenula anomala,Rhodotorula rubra,Saccharomyces cerevisiae,Sporobolomyces salmonicolor, andTrichosporon beigelii. MICs were determined according to a procedure under evaluation by the National Committee for Clinical Laboratory Standards (NCCLS) for broth microdilution testing of filamentous fungi and by the NCCLS M27-A broth microdilution method for yeasts. The in vitro activities of voriconazole were similar to or better than those of itraconazole and amphotericin B againstAspergillusspp.,Fusariumspp., andP. boydiias well as againstB. dermatitidisandH. capsulatum. The activities of voriconazole were also comparable to or better than those of amphotericin B, fluconazole, and itraconazole against most species of yeasts tested. Exceptions were certain isolates ofR. rubraandS. salmonicolor. These results suggest that voriconazole has a wide spectrum of activity in vitro; its effectiveness in the treatment of human mycoses is under evaluation in clinical trials.