Beschreibung:
<jats:title>ABSTRACT</jats:title><jats:p>Terbinafine is active in vitro against a wide range of pathogenic fungi, including dermatophytes, molds, dimorphic fungi, and some yeasts, but earlier studies indicated that the drug had little activity against<jats:italic>Candida albicans</jats:italic>. In contrast, clinical studies have shown topical and oral terbinafine to be active in cutaneous candidiasis and<jats:italic>Candida</jats:italic>nail infections. In order to define the anti-<jats:italic>Candida</jats:italic>activity of terbinafine, we tested the drug against 350 fresh clinical isolates and additional strains by using a broth dilution assay standardized according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS) M27-A assay. Terbinafine was found to have an MIC of 1 μg/ml for reference<jats:italic>C. albicans</jats:italic>strains. For 259 clinical isolates, the MIC at which 50% of the isolates are inhibited (MIC<jats:sub>50</jats:sub>) of terbinafine was 1 μg/ml (fluconazole, 0.5 μg/ml), and the MIC<jats:sub>90</jats:sub>was 4 μg/ml (fluconazole, 1 μg/ml). Terbinafine was highly active against<jats:italic>Candida parapsilosis</jats:italic>(MIC<jats:sub>90</jats:sub>, 0.125 μg/ml) and showed potentially interesting activity against isolates of<jats:italic>Candida dubliniensis</jats:italic>,<jats:italic>Candida guilliermondii</jats:italic>,<jats:italic>Candida humicola</jats:italic>, and<jats:italic>Candida lusitaniae</jats:italic>. It was not active against the<jats:italic>Candida glabrata</jats:italic>,<jats:italic>Candida krusei</jats:italic>, and<jats:italic>Candida tropicalis</jats:italic>isolates in this assay.<jats:italic>Cryptococcus laurentii</jats:italic>and<jats:italic>Cryptococcus neoformans</jats:italic>were highly susceptible to terbinafine, with MICs of 0.06 to 0.25 μg/ml. The NCCLS macrodilution assay provides reproducible in vitro data for terbinafine against<jats:italic>Candida</jats:italic>and other yeasts. The MICs for<jats:italic>C. albicans</jats:italic>and<jats:italic>C. parapsilosis</jats:italic>are compatible with the known clinical efficacy of terbinafine in cutaneous infections, while the clinical relevance of its activities against the other species has yet to be determined.</jats:p>