CoChat
Sign Up
Cited by 361Antifungal resistance and susceptibilityBacterial Identification and Susceptibility TestingFungal Infections and Studies

Has antifungal susceptibility testing come of age

Rex, John H., Pfaller, Michael A.·2002·Clinical Infectious Diseases
DOI 10.1086/342384
Open this paper in CoChat — free account

Abstract

The in vitro susceptibility of an infecting organism to the antimicrobial agent selected for therapy is one of several factors that influence the likelihood that therapy for an infection will be successful. To appreciate the value of antifungal susceptibility testing, it is helpful to review the overall predictive utility of antibacterial susceptibility testing. After >30 years of study, in vitro susceptibility can be said to predict the response of bacterial infections with an accuracy that is well summarized as the "90-60 rule": infections due to susceptible isolates respond to therapy approximately 90% of the time, whereas infections due to resistant isolates respond approximately 60% of the time. On the basis of a growing body of knowledge, standardized susceptibility testing for selected organism-drug combinations (most notably, Candida species and the azole antifungal agents) has been shown to have similar predictive utility. Antifungal susceptibility testing is now increasingly and appropriately used as a routine adjunct to the treatment of fungal infections.

Integrity signals

Registry

Crossref · 10.1086/342384

Cites

64 of 64 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Pfaller et al. set forth fluconazole clinical breakpoints that met the so-called "90-60" rule, whereby treatment success is achieved for ~90% of susceptible isolates and ~60% of non-susceptible isolates.

    “Pfaller et al. [46] set forth fluconazole clinical breakpoints that met the so-called “90–60” rule, whereby treatment success is achieved for ~90% of susceptible isolates and ~60% of non-susceptible isolates.”

    From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [46]

  • Susceptibility testing to fluconazole using CLSI or EUCAST broth microdilution methodology produces MIC values that correlate reasonably well with the likelihood of successful treatment outcomes.

    “Susceptibility testing to fluconazole using CLSI or EUCAST broth microdilution methodology produces MIC values that correlate reasonably well with the likelihood of successful treatment outcomes [46,47].”

    From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [46]

  • Intensive efforts to develop standardized, reproducible, and clinically relevant susceptibility testing methods for fungi have resulted in the NCCLS M27-A methodology (now updated with the essentially identical M27-A2 methodology) for susceptibility testing of yeasts.

    “Intensive efforts to develop standardized, reproducible, and clinically relevant susceptibility testing methods for fungi have resulted in the development of the NCCLS M27-A methodology (now updated with the essentially identical M27-A2 methodology) for susceptibility testing of yeasts [27,28].”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [27]

  • Susceptibility data may be used to support a change in therapy from a parenteral agent of any class to oral fluconazole.

    “Second, the data may be used to support a change in therapy from a parenteral agent of any class to oral fluconazole.”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [27]

  • Susceptibility testing is useful in the evaluation of the possible causes of lack of clinical response.

    “First, susceptibility is useful in the evaluation of the possible causes of lack of clinical response.”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [27]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Rex, J. H., & Pfaller, M. A.
Affiliations
  • Texas Medical Center (US)
  • University of Iowa (US)
Corresponding author
Rex, John H.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2002-10-15
Volume
35
Issue
8
Pages
982-989
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/342384
OpenAlex
W2118836068
Cited by
361
References
64
Citations by year
2026: 5 · 2025: 5 · 2024: 10 · 2023: 11 · 2022: 13 · 2021: 8 · 2020: 17 · 2019: 10 · 2018: 16 · 2017: 21 · 2016: 13 · 2015: 14 · 2014: 24 · 2013: 17 · 2012: 14
FWCI
10.38
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
antifungal susceptibility testing, in vitro susceptibility, predictive utility, antifungal resistance, Candida species, azole antifungals, fungal infection, treatment response
MeSH terms
Amphotericin B, Antifungal Agents, Azoles, Candida, Clinical Trials as Topic, Flucytosine, Humans, Microbial Sensitivity Tests, Statistics as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review