The Evolving Role of Antifungal Susceptibility Testing

Although increasing numbers of hospital microbiology laboratories are performing antifungal susceptibility testing (AST), its routine use is uncommon. The utility of AST is founded on the belief that susceptibility (or resistance) of an agent allows some prediction of clinical outcome. This review p...

Full description

Saved in:
Bibliographic Details
Published in:Pharmacotherapy 2013-05, Vol.33 (5), p.465-475
Main Authors: Eschenauer, Gregory A., Carver, Peggy L.
Format: Article
Language:English
Subjects:
Antifungal Agents - administration & dosage
Antifungal Agents - pharmacology
Antifungal Agents - therapeutic use
antifungal susceptibility testing
antifungals
azole antifungal
Biological and medical sciences
clinical breakpoints
Clinical outcomes
Drug Resistance, Fungal
echinocandin
epidemiological cut-off value
fluconazole
Fungal infections
Humans
Medical sciences
Medical treatment
Microbial Sensitivity Tests - methods
Mycoses - drug therapy
Mycoses - microbiology
Pharmacology. Drug treatments
Practice Guidelines as Topic
resistance
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Although increasing numbers of hospital microbiology laboratories are performing antifungal susceptibility testing (AST), its routine use is uncommon. The utility of AST is founded on the belief that susceptibility (or resistance) of an agent allows some prediction of clinical outcome. This review provides an overview of the development of antifungal susceptibility testing methodology, including wild‐type minimum inhibitory concentration (MIC) distributions, epidemiologic breakpoints, and Interpretive Clinical Breakpoints for antifungal agents. In addition, we examine the current clinical utility of AST and the clinical data support utilized in the development of clinical breakpoints (CBP) for common pathogens causing invasive fungal infections. In the treatment of fungal infections, identifying consistent correlations between MICs – or susceptibility category – and clinical outcomes is an ongoing challenge, and current data sets are insufficient for many drugs and pathogens to enable the development, revision, or confirmation of CBPs. Antifungal susceptibility testing is of current value, but further research in many areas is needed before MICs are independently used to guide treatment decisions.
ISSN:0277-0008
1875-9114
DOI:10.1002/phar.1233