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Antifungal susceptibility testing

Author
Michael A Pfaller, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Anna R Thorner, MD

INTRODUCTION

The need for reproducible, clinically relevant antifungal susceptibility testing has been prompted by the increasing number of invasive fungal infections, the expanding use of new and established antifungal agents, and recognition of antifungal resistance as an important clinical problem [1-4].

The collaborative efforts of numerous investigators and the Clinical and Laboratory Standards Institute (CLSI, formerly National Committee for Clinical Laboratory Standards [NCCLS]) Subcommittee on Antifungal Susceptibility Testing have generated consensus documents describing standardized methods for broth- and agar-based antifungal susceptibility testing [5-10]. As a result, in vitro antifungal susceptibility testing plays an increasingly important role in guiding therapeutic decision making, as an aid in drug development studies, and as a means of tracking the development of antifungal resistance in epidemiologic studies [3,11,12].

An overview of antifungal susceptibility testing will be presented here. The pharmacology and use of antifungal agents for the treatment of specific fungal infections are discussed separately. (See "Pharmacology of azoles" and "Pharmacology of amphotericin B" and "Pharmacology of flucytosine (5-FC)" and "Treatment of candidemia and invasive candidiasis in adults" and "Treatment and prevention of invasive aspergillosis" and "Mucormycosis (zygomycosis)" and "Mycology, pathogenesis, and epidemiology of Fusarium infection".)

An overview of antibacterial susceptibility testing is also presented elsewhere. (See "Overview of antibacterial susceptibility testing".)

OVERVIEW

Rationale — The primary objective of in vitro susceptibility testing is to predict the impact of administration of the tested agent on the outcome of infection caused by the tested organism or similar organisms [3,13]. In this way, antifungal testing is performed for the same reasons that antibacterial testing is performed [3]:

                                  

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Literature review current through: Nov 2016. | This topic last updated: Sat Jul 02 00:00:00 GMT+00:00 2016.
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References
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