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Increased susceptibility of Cryptococcus neoformans to amphotericin B in the presence of steroids.

The in vitro inhibitory effects of amphotericin B in the presence of estradiol, norethynodrel, testosterone, progesterone and diethylstilbestrol on 7 human isolates of C. neoformans was determined. At 4 days of incubation at 25°C the growth of all isolates was completely suppressed by 0·5 μg/ml of diethyl-stilbestrol plus 0·3 μg/ of amphotericin B, while either compound by itself did not suppress growth. At 4 days, 0·01 μg of estradiol plus 0·3 μg/ml of amphotericin B completely suppressed the growth of 5 isolates, while either compound failed to suppress growth completely. The minimal inhibitory concentration of estradiol, diethylstilbestrol, in combination with amphotericin B is much lower than with the steroids alone or amphotericin B alone. Amphotericin B with diethylstilbestrol might be more effective in the treatment of cryptococcal meningitis than amphotericin B. alone.