In vitro efficacy of liposomal amphotericin B, micafungin and fluconazole against non-albicans Candida species biofilms

Non-albicans Candida species are being isolated with increasing frequency. In this study, biofilm formation by Candida tropicalis, Candida parapsilosis and Candida glabrata was evaluated and the activities of liposomal amphotericin B (LAB), micafungin (MFG) and fluconazole (FLC) against these biofilms were assessed using a clinically relevant in vitro model system. LAB exhibited strong activities against the three non-albicans Candida species and showed dose-dependent efficacy. MFG displayed a paradoxical growth effect against the C. tropicalis biofilm. FLC was ineffective for non-albicans biofilms. This study shows that Candida biofilms have unique susceptibility to LAB. The dose-dependent effects of LAB indicate that this drug may be a useful treatment for biofilm formation by non-albicans Candida species in cases in which the catheter cannot be removed for clinical reasons.