Comparison of E-Test, disk diffusion and a modified CLSI broth microdilution (M 38-A) method for in vitro testing of itraconazole, fluconazole and voriconazole against dermatophytes.

We compared two agar-based methods, the E-test and the disk diffusion method with the Clinical Laboratory Standards Institute (CLSI) reference broth microdilution method (CLSI M38-A; MD). Forty six dermatophytes strains including 30 Trichophyton mentagrophytes, 8 T. rubrum and 8 M. gypseum were tested against three antifungal agents, i.e., fluconazole (FLC), itraconazole (ITC) and voriconazole (VRC). The level of agreement between the E-test and MD (+/-2 dilutions) was 45.6% for fluconazole, 19.5% for itraconazole and 52.1% for voriconazole. The results obtained with disk diffusion had low correlation with the results obtained by the CLSI broth microdilution reference method with azoles.