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------=_NextPart_01C2D2AB.A22F13B0 Content-Location: file:///C:/8D2AD50C/invivocorrel_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C2D2AB.A22F13B0 Content-Location: file:///C:/8D2AD50C/invivocorrel_files/slide0022.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" In vitro-In vivo Correlation: Where do we stand?
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Wh= y do Antifungal Susceptibility Testing?
•To correl= ate in vitro MIC data with clini= cal outcome so as to predict the likely outcome of therapy •To monito= r the development of resist= ance •To predict the therapeutic potential of investigational agents
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Current Methodologies for Antifungal Susceptibility Testing
•I.   Broth dilution
•      a. M27 and M38 (NCCLS):  Methods for
•        = ;    yeast and mould testing available.
•        b. Colorimetric: A reagent (e.g. Alamar blue or
•        = ;    XTT) added to enhance clarity of endpoint.
•II.  Agar based
•        a. Etest stable gradient of drug on a plastic
•        = ;   strip is transferred to agar.
•     b. BioMIC disk-diffusion assay
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Where are we in AST?

Yeast (Candida)
•Establishment of standard method for AST is completed
̵= 1;M27-A document
•Relevant drugs:&n= bsp; fluconazole, itraconazole, 5-fluorocytosine, amphotericin B, voriconazole
̶= 6;In vitro - in vivo correlation established
̶= 6;Interpretive breakpoints proposed
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Colo= rimetric Method for Yeast Testing
•Broth dil= ution method with addition of Alamar blue reagent •Color cha= nges from blue to red in the presence of growing yeast •Colorimetr= ic vs M27:  Agreement was 97-99% for Flu and Itra
<= span style=3D'font-size:103%'>•Recently approved by FDA
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