特比萘芬与氟康唑或伊曲康唑体外联合抗白念珠菌的作用

目的探讨特比萘芬与氟康唑或伊曲康唑体外联合抗白念珠菌的作用。方法采用微量液体稀释法测定特比萘芬、氟康唑、伊曲康唑对生殖器部位分离的36株白念珠菌药敏试验，应用棋盘微量稀释法测定特比萘芬与氟康唑或伊曲康唑对36株白念珠菌的联合药敏试验。结果白念珠菌菌株对氟康唑、伊曲康唑、特比萘芬耐药株分别为3株（8．33％）、4株（11．11％）、6株（16．67％）。特比萘芬和氟康唑联用MIC几何平均数较其单独应用均显著降低（t=3．590，P〈0．05；t=3．252，P〈0．05），15株有协同作用（42％），18株有相加作用（50％），3株无关作用（8％）；特比萘芬和伊曲康唑联用后的MIC几何平均数较其单独应用均显著降低（t=3．849，P〈0．001；t=2．409，P〈0．05），表现为协同作用有14株（39％），相加作用的有17株（47％），无关作用的有5株（14％）；均未发现拮抗作用。结论特比萘芬与氟康唑或伊曲康唑联合应用对大部分白念珠菌能产生协同作用和相加作用，提示特比萘芬与氟康唑或伊曲康唑联合应用能增强抗白念珠菌的作用。

In vitro interaction of terbinafine with fluconazole or itraconazole against Candida albicans

Objective To investigate the interaction between terbinafine and fluconazole or itraconazole against Candida albicans.Methods The minimum inhibitory concentrations(MIC) of 36 clinical isolates of Candida albicans from genital locus was determined by broth microdilution method recommended by NCCLS.A checkerboard microdilution method was used to study the in vitro interaction of terbinafine with fluconazole or itraconazole.Results The incidence of Candida albicans resistant isolates were 8.33%(fluconazole),11.11%(itraconazole) and 16.67%(terbinalfine).The geometric mean MIC of terbinafine combinated with fluconazole was significantly lower than that of the single agent(t=3.590,P<0.05;t=3.25,P<0.05).Forty-two percent(15/36) of interactions were synergy,fifty percent(18/36) additive,and eight percent((3/36)) indifferent.Terbinafine in combination with itraconazole significantly reduced the geometric mean MIC than the single agent(t=3.849,P<0.001;t=2.409,P<0.05).39%(14/36) of interactions were synergy,47%(17/36) were additive,and 14%(5/36) were indifferent.Antagonism was not observed in any drug combination.Conclusions The combination of terbinafine with either fluconazole or itraconazole can produce synergism and /or addition in most strains of Candida albicans in vitro.