Amphotericin B in vitro resistance is associated with fatal Aspergillus fl avus infection IN È

uence the outcome of IA are drug pharmacokinetics, site of infection, host factors, and the infecting fungus characteristics, including its susceptibility to the drug. In this setting, in vitro antifungal minimal inhibitory concentration (MIC) determination cannot reliably predict in vivo clinical outcome in a patient. In practice, while it may not always be possible to identify which patients will respond to therapy, in vitro susceptibility tests may be used to identify those who will have a decreased probability of responding. Lassl-Fl ö rl [2] recently reviewed the confl icting data, including those of experimental models of in vivo correlation of antifungal susceptibility testing results in Aspergillus spp. Three clinical studies found a tendency towards a correlation of amphotericin B (AMB) MIC with IA outcome. Only the fi rst one [3] was statistically signifi cant, the Received 6 December 2011 ; Received in fi nal revised form 11 March 2012; Accepted 6 April 2012 Correspondence: St é phane Ranque, Aix-Marseille Universit é , Parasitologie-Mycologie, Marseille, France. E-mail: [email protected] Amphotericin B in vitro resistance is associated with fatal Aspergillus fl avus infection