不同分数抑菌浓度解读标准评估抗真菌药物体外联合效应比较  

Comparision of different interpretation criterions of fractional inhibitory concentration for evaluating the in vitro combined effect of antifungal agents

作　　者：吴伟伟[1] 王千[1] 龚杰[1] 万喆[1] 王爱平[1] 李若瑜[1] 

机构地区：[1]北京大学第一医院皮肤性病科,北京大学真菌和真菌病研究中心,北京100034

出　　处：《中国真菌学杂志》2016年第2期85-89,共5页Chinese Journal of Mycology

摘　　要：目的明确酮康唑联合特比萘芬或萘替芬相互作用模式,评估不同分数抑菌浓度解读标准对判断抗真菌药物体外联合效应的影响。方法参考CLSI微量液基稀释法M27-A3和M38-A2方案,采用棋盘微量稀释法对100株分离自临床真菌病患者的菌株进行酮康唑与特比萘芬或奈替芬体外联合药敏试验,包括皮肤癣菌,念珠菌和马拉色菌。采用不同分数抑菌浓度解读标准评估酮康唑与特比萘芬或奈替芬体外联合效应,A标准定义为:FICI≤0.5为协同作用,0.5<FICI≤4为无相互作用,FICI>4为拮抗作用;B标准:FICI≤0.5为协同作用,0.5<FICI≤1为相加作用,1<FICI≤2表示为无关作用,FICI>2为拮抗作用;C标准:FICI<1为协同作用,FICI=1为相加作用,1<FICI≤2为无关作用,FICI>2为拮抗作用。结果A标准与B标准具有较好的一致性,C标准则较为宽松。根据C标准进行解读会明显扩大协同效应范围。结论定义FICI≤0.5为协同作用,0.5<FICI≤4为无相互作用,FICI>4为拮抗作用的解读标准,具有简便、一致性好的优点,值得临床采用。Objective To determine the interaction pattern of ketoconazole combined with terbinafine or naftifine,and to evaluate the effects of different interpretation criterions of fractional inhibitory concentration index（FICI）for the in vitro combined effect of antifungal drugs.Methods According to CLSI M38-A2 and M27-A3,a checkerboard broth microdilution method was performed to investigate the in vitro activities of ketoconazole in combination with terbinafine or naftifine against100 clinical strains isolated from patients with mycosis,including dermatophyte,Candida and Malassezia.Different criterion for the interpretation of fractional inhibitory concentration were employed to evaluate the in vitro combined effect of ketoconazole in combination with terbinafine or naftifine.Standard A：synergy is defined by FICI≤0.5,antagonism by FICI4,and no interaction by FICI〉0.5,but≤4;Standard B：synergy is defined by FICI≤0.5,additive by FICI〉0.5,but≤1,no interaction by FICI1,but≤2,and antagonism by FICI2;Standard C：synergy is defined by FICI≤1,additive by FICI=1,no interaction by FICI〉1,but≤2,and antagonism by FICI〉2.Results Standard A had good consistency with Standard B,Standard C is relatively lenient.According to Standard C,the interpretation might significantly expand the range of synergy.Conclusions The interpretation criterion of fractional inhibitory concentration（Synergy is defined by FICI≤0.5,antagonism by FICI〉4,and no interaction by FICI〉0.5,but≤4）has the advantage of simplicity,convenience and good consistence,and it is worthy of clinical application.

关 键 词：抗真菌药物 联合 药敏实验 分数抑菌浓度 

分 类 号：R978.5[医药卫生—药品]