Combination antifungal therapy: the new frontier

Area of Science:

• Mycology
• Infectious Diseases
• Pharmacology

Background:

• Invasive fungal infections (IFIs) have increased significantly over the past decade.
• The available antifungal treatments for serious IFIs are limited.
• Antifungal drug resistance and high mortality rates are major challenges in treating IFIs.

Purpose of the Study:

• To explore the potential of combining antifungal agents to treat invasive fungal infections.
• To evaluate the synergistic or additive effects of antifungal combinations.
• To highlight the need for further clinical research on antifungal combination therapy.

Main Methods:

• Review of in vitro and animal studies on antifungal drug combinations.
• Analysis of studies investigating synergistic, additive, and antagonistic activities of antifungal combinations.
• Identification of the need for well-controlled clinical trials.

Main Results:

• Some antifungal combinations show synergistic or additive activity against various fungi in preclinical studies.
• Certain antifungal combinations have demonstrated antagonistic effects.
• Evidence suggests combination therapy may be a viable strategy against resistant fungal strains.

Conclusions:

• Antifungal combination therapy is a promising strategy to combat drug resistance and improve outcomes in invasive fungal infections.
• Further well-controlled clinical trials are essential to determine optimal combination regimens.
• Clinical trials must also assess the safety and pharmacoeconomic impact of antifungal combination therapies.