Post-antifungal effect of amphotericin B and voriconazole against germinated Aspergillus fumigatus conidia

Objectives: The post-antifungal effect (PAFE) of amphotericin B and voriconazole on germinated Aspergillus fumigatus conidia was studied using the BacT/Alert detection system based on fungal CO2 production. Methods: Germinated conidia of A. fumigatus were exposed to 1–103 MIC of amphotericin B for 1 and 4 h and to 2.5–403 MIC of voriconazole for 4 and 24 h. After removal of the drug by washing, similar numbers of exposed and control germlings were inoculated into Pedi-BacT culture bottles. CO2 pro-duction was automatically monitored until the bottles signalled positive. The difference in time for positive signals in drug-exposed and control bottles was used to calculate the PAFE. Results: The killing rate of amphotericin B against germlings was both concentration- and time-depen-dent, as has been previously found for actively growing hyphae. Similarly, voriconazole showed fungi-cidal effect after 24 h of exposure, but not after 4 h. Amphotericin B induced a long concentration- and time-dependent PAFE, whereas voriconazole resulted in a short and dose-independent PAFE that was significantly longer after 24 h than after 4 h of exposure. Conclusions: An automated method is presented for the determination of PAFE on filamentous fungi using quantifiable numbers of germinated conidia. In contrast to previous results obtained from conidia, this method could demonstrate a PAFE of amphotericin B on Aspergillus that shared charac-teristics similar to that on Candida spp