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HIV/AIDS-Associated Infection: Saquinavir & miconazole synergistic against C. albicans & C. neoformans


-- Saquinavir and miconazole are synergistic against Candida albicans/C. neoformans.

"Candidiasis and cryptococcosis are the most common fungal diseases among patients suffering from HIV infection. In the present work we assess whether the combined therapies, proteinase inhibitors and antimycotic drugs, could modify the therapeutic effect of antimycotics.

"An in vitro study to evaluate the antifungal effect of saquinavir and antimycotic drugs combination on yeast growth was performed. Strains of C. albicans and C. neoformans from HIV-seropositive patients were used," wrote investigators in Italy.

"Susceptibility tests of yeasts to amphotericin B, 5-fluorocytosine, miconazole and fluconazole, singly and in combination with saquinavir, were performed in two different media.

"In combination, the antimycotic agents and saquinavir were tested at sub-inhibitory concentrations: 0.1-10 mcg/ml-1 and 12.50 mcg/ml-1, respectively. The fractionary inhibitory concentration (FIC) index was also calculated," said C. Casolari and coworkers.

"The results show that the interaction between saquinavir and all the antimycotic drugs never resulted in antagonism. Fluconazole acts in more synergistic way," reported scientists, "no matter which medium is used. The combined therapy miconazole/saquinavir results in synergism, especially in Sabouraud."

Casolari concluded, "The total absence of antagonism and the presence of synergism suggest that a combined therapy could be proposed in the treatment of HIV-seropositive patients to reduce side effects, thanks to the use of lower doses of antimycotic drugs."

Casolari and colleagues published their study in Pharmacological Research (Interaction between saquinavir and antimycotic drugs on C-albicans and C-neoformans strains. Pharmacol Res. 2004 Dec;50(6):605-10.

For more information, contact T. Rossi, University Modena, Department Pharmaceutical Science, Via G Campi 183, I-41100 Modena, Italy.

Publisher contact information for the journal Pharmacological Research is: Academic Press Ltd. Elsevier Science Ltd., 24-28 Oval Rd., London NW1 7DX, England.

The information in this article comes under the major subject areas of HIV/AIDS, Candida species, Saquinavir, Antifungal and Drug Synergism.

This article was prepared by AIDS Weekly editors from staff and other reports.


Casolari C, Rossi T, Baggio G, et al., "Interaction between saquinavir and antimycotic drugs on C. albicans and C. neoformans strains", Pharmacol Res. 2004 Dec;50(6):605-10.

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Information in this article was accurate in January 24, 2005. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.