Relationship between MIC and minimum sterol 14{alpha}-demethylation-inhibitory concentration as a factor in evaluating activities of azoles against various fungal species.

The minimum growth-inhibitory concentrations (MICs) of azole antifungals were compared to their minimum sterol 14alpha-demethylation-inhibitory concentrations (MDICs) for clinical fungal isolates. The ascomycetous Candida yeasts tested were clearly divided into two groups: group I, consisting of C. albicans, C. tropicalis, and C. lusitaniae, had MICs that were much higher than the MDICs, whereas group II, comprising C. glabrata, C. parapsilosis, C. guilliermondii, and C. krusei, had MICs that were approximately equal to the MDICs. In the ascomycetous fungi Aspergillus fumigatus and Sporothrix schenckii, the MICs were indistinguishable from the MDICs. In the basidiomycetous fungi Cryptococcus (Filobasidiella) neoformans, C. curvatus, and Trichosporon asahii, the MICs and the MDICs were practically identical. These results support the notion that there are two distinct classes of fungi differing in their degree of tolerance to sterol 14alpha-demethylation deficiency. These findings have significant implications for both fungal physiology and antifungal chemotherapy.