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Updated: May 29, 2026

Quadruple-Checkerboard: A Modification of the Three-Dimensional Checkerboard for Studying Drug Combinations
Published on: July 24, 2021
Combination therapies for combating antimicrobial resistance.
1Department of Bioengineering and Therapeutic Sciences and the California Institute for Quantitative Biosciences, University of California, San Francisco, CA 94158, USA. fischbach@fischbachgroup.org
Combating antimicrobial resistance requires new strategies like using drug combinations instead of single drugs. This approach targets different pathways, nodes, or the same target in varied ways to enhance efficacy.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Antimicrobial resistance poses a significant global health threat.
- Existing antimicrobial drug development strategies are insufficient to combat this challenge.
Purpose of the Study:
- To highlight combination drug therapy as a promising strategy against antimicrobial resistance.
- To categorize and discuss different types of antimicrobial combination therapies.
Main Methods:
- Review and categorization of existing combination therapy approaches.
- Exploration of naturally occurring microbial combination therapies.
- Discussion of opportunities and challenges for implementing combination therapies.
Main Results:
- Combination therapies can target distinct pathways, different nodes within the same pathway, or the same target through varied mechanisms.
- Micro-organisms naturally produce effective combination therapies.
Conclusions:
- Combination drug therapy offers a viable strategy to overcome antimicrobial resistance.
- Wider adoption of drug combinations faces opportunities and challenges that require further investigation.
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