Susceptibility of Candida albicans and Other Yeasts to Fluconazole: Relation Between in Vitro and in Vivo Studies

In vitro studies of fluconazole have demonstrated that test results can be influenced by several test conditions, including medium composition, pH, and size of the starting fungal inoculum. In studies with Candida albicans, a few isolates have been identified that are markedly more resistant than other strains of the same species; in several in vivo studies of experimental infections, the more resistant isolates have caused infections less susceptible to fluconazole treatment. These findings corroborate a relation between in vitro and in vivo results. With further work it should be possible to define standard methods for use by clinical laboratories in determining fungal susceptibility to fluconazole.