In vitro interaction of itraconazole with amphotericin B, caspofungin, and terbinafine against clinical isolates of Trichosporon asahii.

Treatment of disseminated trichosporosis is still challenging. Itraconazole is a widely used broad-spectrum antifungal drug. In vitro interactions of itraconazole (ICZ) with amphotericin B (AMB), caspofungin (CAS), and terbinafine (TBF) against 18 clinical isolates of Trichosporon asahii were assessed by chequerboard microdilution method. ICZ combined with CAS showed the highest percentage of synergistic effect (72.2%), followed by ICZ/AMB (11%) and ICZ/TBF (11%) combination. Antagonistic effect was not observed. This study demonstrates that itraconazole can enhance the antifungal activity of CAS against T. asahii, suggesting that this combination may be a potential strategy for treating disseminated trichosporosis.