{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:23:21Z","timestamp":1769059401526,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Grant Agreement","award":["102261"],"award-info":[{"award-number":["102261"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Mucormycoses can be treated with the combination of Amphotericin B and Isavuconazole. This study evaluates the effects of these drugs in vitro against 59 strains representing 12 Mucorales. In vitro testing of the two drugs together and alone was performed using the MIC Test strip \u201cEpsilon test synergy-method\u201d (ETSM), which is more standard in clinical practice than microbroth dilution testing. Amphotericin B and Isavuconazole have synergistic\/additive effects against L. corymbifera, R. arrhizus and M. circinelloides. Different effects have been shown for other Mucorales. ETSM can help the clinical management of mucormycosis from a practical point of view, due to its feasibility in the laboratory.<\/jats:p>","DOI":"10.3390\/pathogens12070948","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T01:02:23Z","timestamp":1689728543000},"page":"948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["In Vitro Activity of Isavuconazole and Amphotericin B in Association against Mucorales"],"prefix":"10.3390","volume":"12","author":[{"given":"Gaia","family":"Ortalli","sequence":"first","affiliation":[{"name":"Microbiology and Virology Laboratory, ASST \u201cPapa Giovanni XXIII\u201d, Piazza OMS 1, 24127 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2724-6549","authenticated-orcid":false,"given":"Ester","family":"Oliva","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Laboratory, ASST \u201cPapa Giovanni XXIII\u201d, Piazza OMS 1, 24127 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3971-2008","authenticated-orcid":false,"given":"Giuliana","family":"Lo Cascio","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Laboratory, Ospedale Guglielmo da Saliceto, Via Taverna 49, 29121 Piacenza, Italy"},{"name":"Medical Mycology Committee (CoSM)\u2014Italian Association of Clinical Microbiologists (AMCLI), Via Carlo Farini 81, 20159 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Medical Mycology Committee (CoSM)\u2014Italian Association of Clinical Microbiologists (AMCLI)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-4293","authenticated-orcid":false,"given":"Claudio","family":"Farina","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Laboratory, ASST \u201cPapa Giovanni XXIII\u201d, Piazza OMS 1, 24127 Bergamo, Italy"},{"name":"Medical Mycology Committee (CoSM)\u2014Italian Association of Clinical Microbiologists (AMCLI), Via Carlo Farini 81, 20159 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6934","DOI":"10.1128\/AAC.03261-14","article-title":"In vitro combination of isavuconazole with micafungin or amphotericin B deoxycholate against medically important molds","volume":"58","author":"Katragkou","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1128\/AAC.01530-08","article-title":"In vitro activity of Isavuconazole against Aspergillus species and Mucormycetes according to the methodology of the European Committee on Antimicrobial Susceptibility Testing","volume":"53","author":"Perkhofer","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7882","DOI":"10.1128\/AAC.02107-15","article-title":"Comparison of the EUCAST and CLSI Broth Microdilution Methods for Testing Isavuconazole, Posaconazole, and Amphotericin B against Molecularly Identified Mucorales Species","volume":"59","author":"Chowdhary","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucoromycosis: An initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium","volume":"19","author":"Cornely","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.1128\/AAC.00361-09","article-title":"Safety and outcomes of open-label deferasimox iron chelation therapy for mucormycosis","volume":"53","author":"Spellberg","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3109\/13693786.2011.614964","article-title":"In vitro activity of Amphotericin B against zygomycetes isolate from deep mycoses: A comparative study between incubation in aerobic and hyperbaric atmosphere","volume":"50","author":"Farina","year":"2012","journal-title":"Med. Mycol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/myc.12236","article-title":"Pathogenesis and host defence against Mucorales: The role of cytokines and interaction with antifungal drugs","volume":"57","author":"Roilides","year":"2014","journal-title":"Mycoses"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S93","DOI":"10.1093\/mmy\/myx101","article-title":"Challenge in the diagnosis and treatment of mucormycosis","volume":"56","author":"Skiada","year":"2018","journal-title":"Med. Mycol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101007","DOI":"10.1016\/j.mycmed.2020.101007","article-title":"Mucormycosis treatment: Recommendations, latest advances, and perspectives","volume":"30","author":"Brunet","year":"2020","journal-title":"J. Mycol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1469-0691.2009.02984.x","article-title":"In vitro activity of antifungals against Zygomycetes","volume":"15","author":"Castelli","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1128\/AAC.01512-07","article-title":"In vitro antifungal activities of isavuconazole (BAL4815), voriconazole, and fluconazole against 1007 isolates of Zygomycete, Candida, Aspergillus, Fusarium, and Scedosporium species","volume":"52","author":"Guinea","year":"2008","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e01230","DOI":"10.1128\/AAC.01230-18","article-title":"In Vitro Activity of Isavuconazole against Opportunistic Fungal Pathogens from Two Mycology Reference Laboratories","volume":"62","author":"Pfaller","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.mycmed.2018.02.002","article-title":"Isavuconazole: A new broad-spectrum azole. Part 2: Pharmacokinetics and clinical activity","volume":"28","author":"Ledoux","year":"2018","journal-title":"J. Mycol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.riam.2021.04.003","article-title":"Mucormycosis: Perspectiva de manejo actual y de futuro","volume":"38","year":"2021","journal-title":"Rev. Iberoam. Mycol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1093\/jac\/dkw433","article-title":"Monotherapy or combination therapy of isavuconazole and micafungin for treating murine mucormycosis","volume":"72","author":"Gebremariam","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1086\/589857","article-title":"Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis","volume":"47","author":"Reed","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Borman, A.M., Fraser, M., Patterson, Z., Palmer, M.D., and Johnson, E.M. (2021). In vitro antifungal drug resistance profiles of clinically relevant members of the Mucorales (Mucoromycota) especially with the newer triazoles. J. Fungi, 7.","DOI":"10.3390\/jof7040271"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2435","DOI":"10.1128\/AAC.44.9.2435-2441.2000","article-title":"Interaction between triazoles and amphotericin B against Cryptococcus neoformans","volume":"44","author":"Barchiesi","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1128\/AAC.00880-06","article-title":"Caspofungin in combination with amphotericin B against Candida parapsilosis","volume":"51","author":"Barchiesi","year":"2007","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1128\/AAC.47.4.1416-1418.2003","article-title":"In vitro sinergy of caspofungin and itraconazole against Aspergillus spp.: MIC versus Minimal Effective Concentration end points","volume":"47","author":"Shalit","year":"2003","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_21","first-page":"970","article-title":"In vitro interaction ov voriconazole and anidulafungin against triazole-resistant Aspergillus fumigatus","volume":"48","author":"Seyedmousavi","year":"2004","journal-title":"Antimictob. Agents Chemother."},{"key":"ref_22","first-page":"796","article-title":"In vitro evaluation of double and triple combinations of antifungal drugs against Aspergillus fumigatus and Aspergillus terreus","volume":"57","author":"Dannaoui","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_23","unstructured":"Lorian, V. (1991). Antibiotics in Laboratory Medicine, The Williams & Wilkins Co.. [3rd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3973","DOI":"10.1128\/AAC.05035-14","article-title":"Optimization of polyene-azole combination therapy against aspergillosis using an in vitro pharmacokinetic-pharmacodynamic model","volume":"59","author":"Siopi","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/myc.12247","article-title":"Mucormycosis in haematological patients: Case report and results of prospective study in Saint Petersburg, Russia","volume":"57","author":"Klimko","year":"2014","journal-title":"Mycoses"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e00838-19","DOI":"10.1128\/AAC.00838-19","article-title":"Evaluation of the Gradient Concentration Strip Method for Antifungal Susceptibility Testing of Isavuconazole and Comparators for Mucorales Species","volume":"63","author":"Vidal","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1128\/JCM.00134-07","article-title":"Multicenter evaluation of a new disk agar diffusion method for susceptibility testing of filamentous fungi with voriconazole, posaconazole, itraconazole, amphotericin B, and caspofungin","volume":"45","author":"Iqbal","year":"2007","journal-title":"J. Clin. Microbiol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/7\/948\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:14:16Z","timestamp":1760127256000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/7\/948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,18]]},"references-count":27,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["pathogens12070948"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12070948","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,18]]}}}